With healthcare leaders focused on complying with balance billing requirements set forth by the CARES Act and being compassionate during a time of uncertainty and stress for many Americans, those leaders who are HBI members continue to report that collection often is not attempted prior to or at the point of service. Discussions surrounding patient financial obligations have similarly ceased. This may be limited to symptomatic or COVID-specific patients, but in other cases, these conversations may be avoided across service lines or all patients.
More people will be affected financially from the pandemic than clinically. As of June 23, there had been 2.3 million COVID-19 cases identified in the U.S. according to the New York Times, but also approximately 20 million continuing unemployment claims according to the latest available data from the U.S. Department of Labor. With so many patients losing their employer-based health insurance, stopping important patient financial discussions is not the answer.
Imagine going to the hospital for any condition during a pandemic rife with misinformation and uncertainty. Mix that feeling with the crossroads many patients face when deciding whether to seek care: are my symptoms bad enough to take on another bill? Then, as they are tested, medicated, or visited by a clinician, they visualize the bills adding up. By the time they are in a bed or listening to final treatment instructions, all they can think about is that final bill. How bad will it be?
The most compassionate thing to do is to take the wonder and worry out of their care. This means educating patients about their financial obligations as early as possible. Empower them to make the arrangements that best suit their unique circumstances. Every patient deserves to know what to expect and how the organization can assist them in paying their balance. They need price transparency—not unresolved bills. At a time when organizations are expanding their payment options and offering increased flexibility, there is an opportunity and responsibility to show that the organization is advocating for patients’ financial and clinical well-being.
Providing more patient financial options
Following this approach, organizations can:
- Communicate that the organization will continue to provide estimates and send statements per usual, but that staff are available to discuss options customized to the needs of each patient.
- Offer flexibility through no-interest payments plans, including 60- to 90-day deferrals, smaller monthly payments, longer repayment terms, and delayed due dates.
- Add a checkbox on financial assistance applications or statements and asking patients upfront if they have been financially impacted by COVID-19.
- Advertise the ability to assist with Medicaid eligibility and enrollment, and working with external partners that specialize in finding external funding for patients.
- Use insurance eligibility and discovery tools more frequently to identify potential coverage on the patient’s behalf.
- Cover the cost of COBRA premiums for patients losing employer-sponsored coverage and who are facing substantial medical bills, whether through internal funds, affiliated charitable foundations, or other external sources.
- Continue to offer a prompt pay and/or self-pay discount to encourage those who can pay to resolve their balance.
- Stop placement with collection agencies, or otherwise foregoing credit bureau reporting and ensuring external agencies are offering the same flexibilities.
- Expand self-service options such as allowing patients to apply for financial assistance, establish or reset payment plan arrangements, or request a deferral.
- Consider adjusting financial assistance policies temporarily, for instance, if the total bill reaches 1%-2% of their current income.
Ensuring staff are equipped for a changing dynamic
If staff are encouraged to avoid financial conversations now, the pathway back to transparent patient financial conversations will become difficult. Even if these touch points have remained, training may need revisiting as yesterday’s approach may no longer be relevant. Staff will need to understand how to be even more empathetic, compassionate and creative in order to meet patients where they are. Now is the time to notify staff, reequip them and address their hesitancies.
To do so, HBI’s Director of Provider Learning Noelle Wysocki recommends:
- Survey staff to learn about their most pressing concerns. Make sure you address any key themes in your training.
- Unify messaging. Provide the same training, tools and directives to all department and clinic staff. Otherwise, patients may be left confused.
- Go beyond scripting. Set staff up for success in any interaction by focusing on soft skills, empathetic communication concepts and customizable techniques. It is impossible to address every scenario staff may encounter, but providing this type of help can prepare them for a variety of discussions.
- Allow for discussion and practice. Have staff discuss situations they run into and even express objections, then work as a team to overcome them.Spend less time explaining what constitutes soft skills and more time exercising them.
- Reinforce customer service. Focus on giving patients the information needed to proactively make the right arrangements for themselves and their families. The goal should not be collection, but financial education, preparedness and assistance.
- Ensure staff are well versed in the options available. Challenge them to view themselves as a true advocate for patients’ financial health.
To best serve their communities, healthcare providers must remain steadfast in informing patients what they owe and how they can resolve their balances or obtain assistance. Organizations have a responsibility to prepare their staff to act as advocates of financial health. If your organization wants help in this endeavor, HBI is here! Get in touch to learn about our soft skill-focused workshop, “Point-of-Service Collections: Empathy, Education, Empowerment,” among other available resources.
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