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The Role of Patient Responsibility in Health Collections

By: John Cook, Chief Client Officer

Healthcare providers are seeing increasing patient liabilities outside of the normal realm of self-pay accounts. Insured are facing higher deductibles, less coverage, and sometimes a larger balance after insurance has paid.

I, for one, experienced shock when I received my first statement stating my responsibility. Some knowledge of what to expect would have allowed me to plan financially for this procedure.

Providers have the opportunity to communicate expectations to the patient through a well-planned and initiated process at pre-admission or admission. It also provides the opportunity to communicate what their responsibility will be and even collect a portion of the patient’s potential liability.

Pre-Encounter is an opportunity to make this happen.

Following are some ideas to consider such a new process:

  • Ask the question, How well and how early do I communicate patient responsibility?
  • What are my opportunities now?
  • Are the processes I have in place working?
  • How good is the information I am getting from the patient?
  • Is scheduling centralized?
  • Am I able to estimate charges prior to patient contact or visit?
  • Are staff trained to communicate liabilities to the patient?
  • Do I have options in place for those that are unable to pay in full?
  • Is my collection policy and procedure up to date and supported by senior management?
  • What new efficiencies do I want to realize?

Pre-Encounter has great advantages; however, it must be well thought out and fully supported by everyone involved. Providers can experience lower denial rates from good information. Patients will have a better understanding of their responsibility and their satisfaction will increase.