Empowering patients to pay

Collecting patient payments isn’t a new or unique challenge for physician practices, and Central Maine Orthopaedics, Auburn, with 15 physicians who provide orthopaedic surgery, podiatry, sports medicine, and pain management to 30 patients a day, was no exception.

We treat patients who have high-deductible health plans and are not accustomed to shouldering such a large financial responsibility. In just five years, patients with employer-sponsored health plans have faced a 47 percent increase in their deductibles, according to a recent Washington Post article.¹

By Kathie Phillips, Supervisor of Revenue Cycle Operations, Central Maine Orthopaedics

Our patients face challenges making large payments in full for costly surgeries, such as knee or hip replacements. To improve collections, we switched to Navicure’s software platform and tripled the amount of payments taken via automated scheduling within the first six months. With a new process, we’ve been able to begin having payment conversations with patients much sooner, which allows us to get payment plans scheduled.

The average cost to generate and mail a paper statement is about $7,² and we now send 28 percent fewer paper statements. By transitioning away from paper-based collection processes, we substantially reduced our cost to collect. In fact, our organization saves almost $11,000 each quarter in reduced spending on paper statements.

Abandoning manual processes

Before the transition, staff asked for payment when patients checked in. We offered payment plans, but patients frequently didn’t make full payments, and installment minimums were too low – which made the payback period too long and unsuccessful.

With a heavy workload, staff frequently complained about feeling overwhelmed. Across four locations, each office had only one or two credit card machines. When staff members processed payments, they had to leave the patient to swipe a credit card, and the patient often waited for their turn to use the swipe machine. It was especially cumbersome when taking information by phone. The card information would have to be captured, which led to a backlog at the end of the day when staff had to process all payments taken by phone.

We wanted to develop a truly patient-friendly process that offered flexible options for how and when to pay.

Patient-friendly payment strategies

We implemented a new payment process along with Navicure Payments, a patient-payments platform that automates much of our previously manual work. After discussing patient financial responsibility at check-in, our staff presents options, such as making a down payment or setting up a recurring scheduled payment plan in which staff and patients agree on the amount and payment date.

Each computer is equipped with a plug-in USB swipe device, which increases efficiency and security of patient information, since it eliminates the previous step of writing down credit card information to key in later. The platform also allows staff to securely store credit or debit card information for charges once patient responsibility is determined.

Our days in accounts receivable (AR) greater than 120 was through the roof – as high as 32 percent, which is another reason we knew we needed to tackle our patient-payment problem to support patients and improve cash flow.

Tips for increasing payments revenue

During the implementation process, our team gained many insights regarding patient-payment behavior and how to improve the payments process, such as:

Give front-office staff the ability to focus on the patient. They need to be able to devote their full attention to explaining patient estimates, discussing options, and collecting payment. Ideally, staff members should be able to conduct the entire payment process without leaving their workstation or the patient.
Provide patients with information about their payment responsibility as soon as possible, and no later than at the time of care.
Understand that most patients want to pay your practice in full. If they seem reluctant to pay, it’s likely they’re concerned about the amount. Focus on them and discuss how and when they can pay.
Offer multiple options for patients to pay their remaining balance. Patient preferences are varied, and some might prefer online or automated options. If the amount is more than $200, patients might need flexible options, such as payment plans.
Analyze your overall cost to collect, and pinpoint the high-cost areas. Most often, post-service communications such as paper statements and phone calls create the highest cost. Find ways to change high-cost processes.

As our practice continues to grow and serve the needs of the community, staff and leadership are pleased we’re able to arm patients with the tools and information they need to pay for their care.

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