How To Tell If Your Self-Pay Vendors Are Providing A Positive Patient Financial Experience

by | Aug 12, 2021

We hear all the time about the rise of healthcare consumerism as though it’s a growing trend headed our way. Actually, it’s already here, and many hospitals are struggling to catch up. This is especially true for those still using revenue cycle processes designed solely around payer reimbursement. Since patients are now the third-largest payer behind Medicare and Medicaid, hospitals need a new approach, one designed around the patient financial experience.[1]

But what do you do if you outsource patient collections, patient access, or patient billing? How can you be sure your vendors have progressed in their own processes to accommodate today’s new consumer-centric financial model? As the industry’s first “at-risk” vendor performance management company, we’ve seen it all and can say with certainty that not all vendors are created equal. And when it comes to vendors who engage with your patients in a financial realm, not knowing which is which can damage your hospital’s brand reputation, your patient satisfaction ratings, and your bottom line.

When hospitals emphasize the importance of the patient experience, they can improve brand loyalty and gain a competitive advantage.[2]

Following are five questions that can help ensure your vendors understand their role in providing your patients with a positive patient financial experience.

Do they understand their impact on your hospital’s reputation?

Research shows that a negative patient financial experience can completely offset a positive clinical experience and lead your patients to switch providers for their future healthcare needs. It’s essential that your vendors have quality control and continuous improvement processes in place to ensure an optimal patient experience at every engagement. Do they monitor patient calls? Do they have training for their call center agents? How high is their turnover? These are important questions to ask. If your vendor can’t answer them, it may be time to renegotiate your SLAs, reset expectations, or look for a new partner.

Do they take ownership of the patient relationship and hold themselves accountable?

The patient financial experience is a reflection of your hospital’s culture. It’s important that your vendors understand this concept and embrace your hospital’s unique culture as their own. Do they treat your patients with respect? Are they empathetic to the patient’s financial situation? Do they act as advocates focused on helping patients pay, rather than adversaries just trying to get their money? Vendors need to understand they are the face of your hospital, and they need to treat every patient as their own customer.

Do they leverage technology to measure effectiveness and validate results?

Our research has found that 64% of hospitals are unhappy with, or uncertain about, their vendors’ performance. Since a typical hospital spends up to a third of its revenue cycle budget on outsourcers, this statistic should be unacceptable.[3] The problem is that each vendor uses its own processes to measure results, and those processes are often skewed in the vendor’s favor. Without in-depth insight and reconciliation of all accounts, hospitals lack the ability to identify vendor performance issues such as double invoicing, noncompliance, or moving viable accounts over to bad-debt collections too soon.

Do they offer patient-centric payment options?

One-size-fits-all collection methods are ineffective. The best vendors will offer a full spectrum of patient-focused solutions that improve financial literacy and make it easier for patients to pay. Patient responsibility estimations can remove much of the confusion around coverage, co-pays, and deductibles and can inform a better conversation about payment options. Propensity-to-pay analytics helps identify each patient’s unique financial situation and opportunities for financial assistance or charity care. The most effective vendors will offer multiple payment options, including digital payments, online payment portals, and self-select payment plans. Plans should provide patients the ability to roll up future charges and those of other family members. Your vendors should understand that removing barriers that make it harder for patients to pay is a much more effective approach than aggressive telephone calls or threatening letters.

Are they open to feedback and remediation?

We’ve conducted multiple reviews of millions of accounts across the country. What we’ve found is that of accounts placed with vendors, more than 36% of those 31 – 60 days and 23% of those 121+ days are never worked. Small-balance accounts, in particular, are often underworked, and those should be the easiest to collect on. Do your vendors follow industry best practices? Do your SLAs clearly outline your expectations? Underperforming vendors should never be tolerated. The best vendors are those willing to work with you or a third party to improve performance and reset expectations. Doing so not only helps you but also benefits the vendor and adds value to the relationship.

How you manage post-discharge billing and final collections can impact a patient’s propensity to use—or recommend—your facility in the future.

A new approach

Hospitals need to view the patient experience in a more holistic way, one that starts when the patient walks through the hospital doors and continues until their bill is paid in full. Those that outsource collections need to understand the critical role their vendors play in this process. And those vendors need to understand the impact they have on a hospital’s brand equity, patient satisfaction, and ability to gain market share. But to be successful, hospitals need visibility into vendor performance. Without insight, you have no way to hold vendors accountable. And without this, you may never achieve optimal returns on your outsourcing investments.