Managing Self-Pays Begins with Education

Editor’s Note: This article is the first in a two-part series by Chuck Seviour.

Patients have a right to know approximate out-of-pocket costs before they receive treatment. It is incumbent upon our patient financial services counselors to engage patients as early as possible and focus on educating them of their financial responsibility.

The need for financial counseling continues to grow as illustrated by the advent of:

• Higher healthcare deductibles
• Higher co-pays
• New Health Saving Account (HSA) policies
• More than 50 million uninsured/underinsured patients

Together these realities create an entirely new revenue situation completely different than the environment many of us remember in years past.

Enter the Financial Counselor

The “upfront financial counselor” has become a pivotal position in healthcare. As employees, we have an obligation to not only assist the patient in understanding his or her out of pocket cost but to educate them about their personal responsibility to pay it!

A Revenue Cycle team must have professional counselors. Many facilities move their counselors from collection positions to upfront positions based on their understanding of the dynamics of self pay and their ability to work with patients to pay their accounts early. This can be accomplished when counselors discuss the requirements of payment prior to the patient receiving service.

Management must support and train staff on collecting money at the time of service. While scripting and expediency are key elements of success for financial counselors, having compassion and treating patients with dignity and respect must be the number one priority when gaining patient commitment to pay.

Assisting patients who are unable to pay prior to treatments or who have large existing balances is an important role. This assistance can include assessing a patient’s liability, linking patients to available funding sources or determining whether they are eligible for charity care or financial hardship treatment.

Patients requesting payment plans or financial hardship assistance must be identified as early as possible in the registration/admission process. Three important factors to remember are:

• Financial counselors will have maximum effectiveness when they reach out to the patient first.
• Collection of money, though the top priority, does not mean non-collection has resulted in a poor call with the patient.
• Educating our patient about their fiscal responsibility is essential to the process.

Continue to Part Two …

About Chuck Seviour

Chuck has over 40 years of healthcare industry experience ranging from Director of Business Office Operations for a large health system to consulting with more than 150 hospitals for a major accounting firm. Chuck has been Vice President of Revenue Cycle for Array Services Group since 2004.

About Array

Array Services Group and its three innovative business units – CareCall, ProSource and J.C. Christensen & Associates – offer professional services in call management disciplines, accounts receivable and revenue cycle management, empowering clients for immediate and future success.