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New Patient Pay Process Improves Financials and Enhances Patient Care

HealthWare Systems Blog

New Patient Pay Process Improves Financials and Enhances Patient Care

Posted on Wed, Oct 23, 2013

workflow management solution and saw uncompensated care costs decrease by $6.5 million a year and Point of Service (POS) collections increase by $1.6 million a year.

But that’s not the whole story.

Botsford, like many healthcare systems, realized that they were losing a lot of money by not actively addressing payment with patients right up front, whether insured or not. Their self-pay patients comprised about 15% of their accounts receivables, which means that by not actively pursuing payment, they were leaving a significant amount of revenue on the table. Botsford’s passive approach of trying to stop or avoid self-pay needed to change. The hospital needed to start actively engaging the self-pay patient.

To meet this new objective, Botsford developed a cohesive plan for its patient payment processes and technologies. They chose HealthWare Systems’ revenue cycle management software (ActiveWare), which gave them access to the insurance verification, payment estimation, and payment processing tools that are necessary for an effective point-of-service (POS) collection process.

However, just as a patient who follows only half the doctor’s orders will not fully recover, Botsford recognized that investing in technology without changing their processes would not help them improve patient payments.

In conjunction with the ActiveWare implementation, Botsford trained its staff in the new software and also implemented new policies to teach them how to have conversations about payment arrangement and payment sources.

Operating under the principle that every self-paying patient deserves to have a discussion about payment, whether it is about identifying the payment source, arranging payments or applying for financial assistance, Botsford sought to develop a payment arrangement that was agreeable to both parties.

The information available in ActiveWare facilitated Botsford’s new POS collection strategy.  For example, ActiveWare allows Botsford registration staff to launch an eligibility check as soon as they enter the patient’s insurance information. On one screen, registration staff can see:

  1. What benefits are available to the patient

  2. Whether the patient is eligible for coverage

  3. If authorization is required for that particular treatment

This critical information allows staff to begin having a conversation with the patient about payment right away. Once eligibility is determined, ActiveWare shows a payment estimation tool, which indicates, based on the patient’s insurance and past history of what the service costs on average, what the estimated out-of-pocket expense will be for the patient. It also can turn this estimate into an easily understandable and simply formatted request for payment, which makes it easy for registration staff to a conversation like, “How would you like to pay for this today?”

These eligibility verification and the payment estimation conversations have been surprisingly well received. Botsford discovered that patients want to know their eligibility and payment options. Even better, the hospital has expanded its patient pay and discounting programs to give patients more options for payment and offer them a prompt pay discount.

But the real story of the ActiveWare solution isn’t about the system implementation. Rather, it’s about how this technology, which enables the collection of payment information and patient-pay responsibilities, helped Botsford improve their bottom line and enhance patient care and communications.

Read the full case study to find out more.

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