The digital transformation that has redefined payment experiences across the business landscape now impacts those organizations in the healthcare ecosystem. Patients expect seamless payment solutions when it comes to their healthcare, with that payment experience impacting the overall patient experience.
Today, healthcare providers and their practices must navigate the increasingly complex demands of modern payment systems. In this article, we’ve gathered everything you need to know about healthcare payment solutions in order to maximize efficiency and deliver exceptional patient experiences.
The healthcare industry is well-known for being behind the curve when it comes to embracing new technologies—even if that means decoding doctor’s handwriting!
Today, however, healthcare providers and medical offices like yours have begun to more actively embrace the evolving technology, including payment solutions, that improve both operational efficiency and patient experience. Healthcare payments can be collected faster, and patients can be more engaged with their healthcare management, improving the process as a whole.
According to a study by PYMNTS, 28.9% of patients have paid a medical bill through an online portal within the last year. Additionally, the study reports, “70% of consumers are open to using a unified digital platform to manage their healthcare needs and activities, with 43% indicating high levels of interest.”
Patient payment processing is no longer an isolated back-office function. Healthcare providers need to ensure they have the software and functionality in place in order for patients to make easy payments at any point in the care process.
Medical billing and patient payments form two critical steps in healthcare revenue cycle management (RCM), which is defined as the business process of accurately collecting payments for services and managing financial operations.
The length of your healthcare revenue cycle can vary depending on a variety of factors, but it typically starts when a patient schedules an appointment and finishes when all payments are reconciled. Healthcare RCM can be performed in house or outsourced to a third-party vendor. Either way, a healthcare payment processor functions as an integral part of the revenue cycle management process for your organization.
During the revenue cycle, practice management must navigate the tricky process of accurately coding and billing visits and procedures correctly, and then they must deal with insurance approval and compliance. Typically, medical practices will utilize electronic medical records (EMRs), which come with their own set of obstacles as well.
Healthcare RCM has many challenges—payment processing should not be one of them.
Many modern healthcare organizations use a fee-for-service (FFS) healthcare system, which has the healthcare provider reimbursed for the specific services completed. While FFS healthcare provides the most flexibility, it can also emphasize the volume of procedures and visits a provider can complete.
Alternatively, value-based care (VBC) is a newer model of healthcare which focuses on whole-person wellbeing, with providers being paid based on patient outcome rather than on procedures and visits.
While VBC is increasingly discussed, FFS providers are still the most common form of healthcare. FFS providers need a flexible healthcare payment software in order to maintain efficiency and deliver a great patient experience.
The healthcare payment structure you utilize can dictate which payment methods you will want to offer your patients. It’s important to consider how often your patients will make payments and what requirements you need for a healthcare payment system to achieve a streamlined patient experience.
Patient payment platforms operate in conjunction with medical billing software to accurately distribute invoices, manage payments, and complete the accounting process to keep your healthcare organization running and providing patient services. Popular patient payment collection methods include the following.
One of the most common times a doctor’s office or medical practice collects a patient payment is at the office when the service is about to be provided. Often this payment is for the co-pay or other noted balance that must be paid prior to the visit.
In-person patient payments can occur through multiple payment methods, including:
These payments can be processed through medical merchant services vendors, which provide the secure and seamless transaction process for medical practices. Patient credit card payments may be completed via a credit card terminal, which then sends the information securely through credit card payment processing software.
When choosing a healthcare payment solution, consider if your staff will be collecting in-person payments, what payment methods you’ll accept, and what level of ease-of-use your staff will require.
When it comes to healthcare, many patients still prefer to make a phone call to handle their appointments and payments. With telephone payments from a healthcare payment solutions provider, you can enhance your patient loyalty by giving them the option to pay on their own time, from anywhere.
FirsTech and similar leading healthcare payment processors offer an Interactive Voice Response (IVR) system, which is an automated voice response system that allows customers to make payments and complete other tasks. IVR can utilize custom scripts and responses based on your patient needs.
IVR systems can be supported by live customer service representatives. When these phone payments are outsourced to a healthcare merchant service provider, no additional software is needed, and the patient payment process is streamlined.
These days it seems like everything can be purchased online—some medical services can even be completed via telehealth appointments. Naturally, online bill pay is becoming increasingly popular when it comes to healthcare.
In order to accept online payments for medical billing, healthcare providers need to partner with a payment gateway provider like FirsTech. Your patient payments can be completed through a single-use link or through a dedicated patient account that allows for easy repeated transactions.
Online payments also offer the option for paperless billing, which is environmentally friendly in addition to being the preferred option for many patients. With many electronic medical records (EMRs) going digital, it makes sense to also see medical payments increasingly use online bill pay services.
Even in today’s digital age, many patients still prefer to make healthcare payments via check. Lockbox services allow medical practices and doctors’ offices to outsource check transactions to a trusted financial partner (like FirsTech).
Patient payments will be sent to a dedicated post office box where they are collected, deposited, and processed by your lockbox banking provider. By utilizing a third-party lockbox service, you can continue to accept check payments from your patients without the extensive workload of completing those transactions.
When it comes to managing medical billing and healthcare payments, your healthcare organization should consider the different touchpoints where your patients may be able to or be required to make a payment. Common patient payment opportunities include the following.
Prior to a visit to a doctor’s office, patients typically will review any relevant information from their insurance provider and the healthcare provider. Some healthcare providers may require a prepayment in order to hold an appointment, but that is not a widely accepted practice due to the variable nature of insurance coverage.
Pre-registration may take place as a part of the pre-visit process, depending on the services provided by your medical practice. This pre-registration can help determine when a patient will pay and what those patient payments may be.
At intake, patients will assume financial responsibility, signing relevant documents. Your payment policies should be clear and accessible to all patients. They may have a predetermined copay for their appointment, if that information is readily provided by the insurance carrier. Any additional financial counseling should also be completed at this step, prior to the medical visit.
Charge capture occurs at and immediately after the point-of-care, with medical administrators assigning medical procedure codes and diagnosis codes for the visit. All parts of the patient-provider interaction should be thoroughly and accurately documented. These claim codes are then converted into revenue by billing insurance and the patient.
Charge capture does not directly involve a patient payment, but it is one of the most important steps of the patient payment process. Poor charge capture can occur through under-coding, over-coding, inaccurate charges, and missing charges. When your medical charges are under-coded, revenue leakage can occur, and over-coding is a serious non-compliance issue that can lead to costly audits and fines.
When payments are accurately collected at point-of-care, the need for extensive medical billing processes is reduced, saving time and money.
The medical billing process is completed after the visit, with a medical billing specialist creating a superbill. A superbill is a formal document featuring patient information, practice information, encounter information, and an itemized list of services with their corresponding medical billing codes.
The superbill is typically submitted first to the patient's insurance provider, and then any outstanding balance is sent to the patient for payment via a patient statement. The patient statement should be accompanied by clear directions to make a payment.
Billing issues are common when it comes to healthcare payments, so follow up is an essential step to prevent revenue loss. Patient statements should be sent in a timely manner, and offering multiple payment channels can increase patient engagement and payment collection.
Additionally, it’s important to consider integration to your EMR or medical practice management software, so patient records are well-aligned. Many doctors’ offices and medical practices are now selecting healthcare payment solutions that feature an easy-to-use payment portal, where they can pay their balance with just a few clicks through a secure platform.
When selecting a partner for your healthcare payment solutions, audit your current medical billing process and the systems you have in place. Consider the following factors when reviewing different healthcare payment solutions providers.
Consider which payment channels you currently accept at your medical practice, as well as which ones are the most popular. Potential payment channels for patient payments can include credit cards, debit cards, HSAs, ACH, paper checks, and cash. Your patient payments may need to be collected in-person through a point-of-sale terminal or online through an online payment gateway.
Healthcare payment processing companies may not all offer the same payment channels or may process those transactions in different ways. For example, consider if your medical practice could benefit from a complete lockbox services solution, allowing patients to send checks for secure processing by a trusted third-party.
When selecting a healthcare payment solution, consider the following software that your medical practice may use:
Many healthcare payment solutions will integrate easily with other popular software platforms that your office uses. If there is not a direct integration between your patient payment platform, consider the time it will take to reconcile the accounts.
Onboarding a new healthcare software can cause stress within your organization, so selecting a new patient payment platform should be done thoughtfully and with maximum buy-in from your team members. Identify pain points and feedback from your staff in order to evaluate different healthcare payment solutions and extrapolate how easy they will be to implement.
An effective healthcare payment system should simplify reconciliation and streamline workflows, not create more work or headaches for staff and patients.
When selecting a partner for healthcare payment systems, security and compliance must be top of mind. Healthcare payments, like other transactions, should follow best practices as outlined by the Payment Card Industry Data Security Standards (PCI DSS). PCI DSS are created by the PCI Security Standards Council to identify technical and operational guidelines for card processing transactions. Your healthcare payment solutions provider should be in compliance with PCI DSS and continually updating their products and processes to stay compliant.
When selecting a payment processor for your healthcare transactions, you should also be mindful of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule and Privacy Rule. Patient payments must be HIPAA-compliant in order to ensure the privacy of protected health information (PHI).
Some patient payment platforms automate communications, including digital communication and paperless billing, which can save your staff valuable time. Communication is a crucial component of a good patient financial experience, so patient communications and customer support options should be carefully considered when choosing a healthcare payment system.
Great healthcare payment processing balances quality patient experience with the financial bottom line of your healthcare practice. By working with FirsTech, you can spend more time with your patients while feeling confident in the optimal performance of your revenue cycle. We offer configurable payment channels that deliver a frictionless payment experience for your patients.
Learn more about healthcare payment solutions from FirsTech by contacting our team today.