HEALTHCARE PROVIDERS AND THEIR PAYMENT PROCESSING PARTNERS SHOULD
SHARE AN IMPORTANT COMMON GOAL:
Any patient can pay at any point in the revenue cycle process (before, during or after an encounter) via any payment type (check, e-check, credit/debit card, online bill pay, payment plan) through any payment outlet (point of service, web, phone, mail, payment plan, kiosk)
Healthcare provider organizations have had a very challenging few years where systems and transaction processing capabilities are finally catching up to the market need to interact with patients in a more direct
collections relationship. Healthcare providers, however, are not providing the level or the sophistication of payments services that consumers expect. Given the challenges healthcare faces that are unique to the
market, and the novelty of providing retail-like payment processing capabilities, it’s not surprising that this is a main focal area for the revenue cycle and financial departments in almost every healthcare
provider organization. Most need updated systems that can enable significant process improvements as well as integrate patient payments into workflow. In the last few years, financial accountability for healthcare payments has largely shifted to consumers.
The Rise of High Deductible Health Plans
As employers look for new ways to handle rising healthcare costs, High Deductible Health Plans (HDHPs), which shift financial accountability to consumers, have matured in the last few years. The U.S. market has
experienced a ten-fold increase in the past seven years in the number of covered lives under HDHPs — to more than 11.4 million people and growing (as of June 2011).
According to America’s Health Insurance Plans (AHIP), the growth in HDHPs is a major contributor to current expectations that out-of-pocket payments for insured patients are expected to grow from $250 billion in 2009 to $420 billion by 2015, a 68 percent increase in five years.
Effects on Patients and Providers
As patient accountability increases under HDHPs, patient medical liability grows as well. Medical liabilities for self-pay patients — those without insurance who pay for services from their own pockets — are now
growing at 19 percent per year.
In stark contrast, for insured patients, McKinsey has estimated that the rate of bad debt is increasing at well over 30 percent each year in some hospitals. Consumers now pay more in healthcare costs than employers, and that consumer bad debt for medical expenses were $65 billion in 2010
Gaps in Healthcare Payments Efficiency
The current systems infrastructure in most provider organizations is not designed to provide the necessary level of detailed, accurate and timely payment processing service to patients. Hospitals and clinics often have manual processes for verifying eligibility, requesting payment, collecting and posting payments and managing exceptions.
Where electronic transaction processing does exist, they often are not integrated into systems and require manual workarounds.
• Patient responsibility is increasing dramatically
• Patients will pay
• Provider organizations have numerous challenges to address patient payment process optimization
Edited By : Dr.Hisham Safadi @hishamsafadi
Published at http://www.leaderhow.com