Solving the Self-Pay and HDHP Patient Collections Conundrum

July 9, 2014 by Experian Health

In the “good old days,” U.S. healthcare was basically free – at least that’s what patients with a good insurance plan believed. You may have had a small co-pay, but if you were employed, chances were that you and your family received comprehensive health insurance that took a barely noticeable bite out of your paycheck.

Fast forward to 2014, and that rosy picture is long gone.

Changing reimbursement models are compounding the financial risk for healthcare providers by placing a greater payment burden on patients. For example, a growing number of employers are adopting high-deductible health plans (HDHP) and/or health savings accounts. The number of people with HDHPs has risen from 19.2 percent in 2008 to 33.4 percent in 2014, as reported by the Centers for Disease Control and Prevention.

Out of necessity, providers are finding themselves in the collections business if they are to protect the bottom line. One of the best tools at their disposal to increase full and fair payment for healthcare services, and which has long been employed by collections agencies? Data and analytics.

Real-time information and advanced data and analytics can help identify the most effective and customized collections approach based upon each patient’s financial situation. This data gives healthcare organizations the full picture of a patient, providing continuous monitoring of unpaid accounts for changes in a patient’s ability to pay.

Obtaining and effectively leveraging that information is just one best practice for healthcare organizations seeking to enhance their collections methodologies. Additional must-have strategies include:

  • Management of internal collections and agency performance with real-time dashboards and reports, and support evaluation and performance improvement. 
  • Use of full-time revenue cycle consultants and data analysts, who work with each account to recommend “best practice” collections and outsourcing strategies, evaluate reports for opportunities and oversee champion/challenger scenarios. 

Times may be changing, but employing a well-coordinated, proactive approach to addressing the self-pay patient and capturing the balance after insurance has paid doesn’t have to be challenging.

Learn how Experian Health and Passport’s patient collections tools work together to help you obtain payment certainty even with today’s new reimbursement models, by combining unmatched insight, real-time data and innovative collections solutions.