Not All Patient Estimation Software is Created The Same

Not All Patient Estimation Software is Created The Same

More patients are paying a larger portion of their medical bills. At the same time, health insurance deductibles are increasing. Employer-sponsored health insurance deductibles have increased from $826 to $1,655 on average over the past 10 years. The number of people enrolled in high-deductible health plans has also increased. These plans typically include a deductible of $1,350 or higher for single coverage and $2,700 for a family. Enrollment in these plans has jumped from 18% to 28% of insured Americans over the past five years. 

As a result, practices are collecting a larger portion of the bill directly from patients, which creates a variety of challenges. One large challenge is that patients expect their insurance plan to cover more of the bill and feel blindsided by the balance. This can result in payment delays, bad debt and financial hardship for practices. 

Cost estimation software helps practices accurately communicate out-of-pocket expenses upfront, collect more revenue, and decrease the risk associated with bad debt. However, not all patient estimation software is created equally. 

A Smooth, Automated Process 

Software should create an accurate estimate of exactly what the patient owes for service. Presenting these costs upfront can prevent the shock to a patient that comes with receiving an unexpected bill, and opens a dialog to communicate your patient’s healthcare billing responsibility early. For example, a patient might have a $20 copayment after they meet the insurance deductible. The office visit cost is $125 and the patient hasn’t yet met their deductible and therefore owes the full amount. Cost estimation software allows the practice to have this conversation about the patient’s financial responsibility at the time of service. Estimating software should consider all potential cost variables, including the following: 

  • Copayments, deductibles, and any co-insurance
  • Service costs based on the most up-to-date contract terms
  • Claims history, eligibility, and benefits for the patient 

An accurate, up-front cost estimate empowers patients with greater visibility, and if there are any challenges to paying for service, those issues can be addressed early in the process to speed up the payment cycle. 

Connects Patients With Payment Plans 

Many patients can’t pay the entire balance upfront. For example, the patient who hasn’t met their deductible and owes $125 might need help paying the bill. Sharing cost details early in the process allows the practice to present resources such as payment plans. 

A fully integrated software solution offers payment plan options to help patients spread payments out over the longer-term. Look for a solution that offers 100% patient approval rates on financing plans. A high approval rate allows you to extend flexible and personalized financing resources to all patients, regardless of their credit history or personal circumstances. 

Designed to Increase Patient Satisfaction 

When patients are happy, you get paid faster. Expectations around the patient experience are higher than in the past. People expect to receive the same level of convenience and service that they get with other service providers, such as retailers, and the value placed on customer service is high. Over half of patients (53 percent) report they value customer service from their healthcare provider. 

Losing a customer due to dissatisfaction is expensive; estimates suggest the potential revenue loss is around $200,000. Patients are constantly sharing referrals with friends and family, and if you satisfy just one patient, that person will tell four people. In contrast, if you alienate one patient, that person will tell 10 people about their negative experience. 

Automated patient estimation software at your practice is designed to create smoother, more satisfactory patient experiences. An effective estimation tool will do the following:

  • Pre-encounter. Provide price transparency and accurate estimates about the patient’s financial responsibility before services are rendered and present financial options upfront. Enroll patients in facility-approved payment plans.
  • Point-of-service. Create treatment plans and discuss outstanding balances at the point of service. Increase case acceptance rates with payment plan options that fit within your patient’s budget.
  • Post encounter. Address patient balances that require financing. Leverage omnichannel communication to drive enrollment in payment plans.

A solution that is fully integrated ensures that the patient experience includes maximum transparency and the person feels truly known and understood by their medical practice. 

Driving Stronger Success and Cash Flow in The Future 

In order to continue serving patients, practices need steady cash flow. Part of securing this healthy cash flow is collecting more at the time of service. Practices have a 70% chance of receiving payment at the time of service, compared with only a 30% chance of successfully collecting it after a patient leaves the practice. 

Patient estimation software is an important tool for collecting more payments and setting up appropriate payment plans, at the point of service in order to increase patient responsibility. The result is better patient satisfaction, more revenue captured earlier in the process and greater patient transparency.