Becker's ASC Review

21 Executive Briefing Sponsored by: Making the patient financial experience a win-win By CareCredit O perating a financially successful outpatient surgery center in today's consumer-driven environment involves unique challenges, as well as opportunities. The patient financial experience has become important in all healthcare environments, but ASCs may be hampered by limited interactions with patients, making it more difficult to impact what they know (and truly understand) about financial aspects of their care. On the other hand, ASCs that make an effort to gain patients' trust by offering valuable insights and helpful guidance to make the financial experience more positive can improve not only overall patient satisfaction, but also their A/R and profitability. A good place to start is by considering the patient journey and the many, often disparate factors that contribute to the overall cost for a given course of care. To healthcare professionals, it may seem obvious that surgeon's fees, facility costs, anesthesia services, post-procedure rehab, medicine, equipment and sup- plies, and so on are all distinct elements provided by often un- related sources, each with its own associated fees, invoices and financial policies. To patients, however, these separate EOBs, fees and invoices can feel like an ongoing bombardment, often hitting when they want and need to be focused on recovery. Layer on premiums, deductibles, co-pays and other out-of- pocket costs, and navigating these bills — let alone paying them — can feel overwhelming. Given this situation, it's no surprise that a recent report found 67 percent of providers said their primary revenue cycle concern is patient receivables. 1 Delivering a better patient financial expe- rience can have a tremendous positive impact for patients and providers alike, making this truly a win-win. Communicate early, clarify often A better financial experience needs to start with patient-centric pre-surgical communications. Patients may not know the ins and outs of a typical outpatient procedure, including the spe- cialists involved, recovery process and timing, and how and what they will be billed. One way to help provide this under- standing is to empower patient access teams and scheduling and pre-op call representatives to act as a kind of "concierge" for the surgery center. They should focus on confidently sharing information and answering questions while conveying an air of confidence along with a dedication to service and support. Of- ten these teams are the only point of contact with the patient, so they need to be comfortable delivering critical information consistently, as well as projecting calm and capably fielding a wide range of questions while managing varied personalities and stress levels. This may not be a natural mindset for some staff members, but it may help to know that patients actually welcome information on costs and payments, and they want to engage in financial discussions. In a recent study, 88 percent of consumers said they want to understand payment responsibility up front. 1 Offer- ing cost estimation tools or fee schedules is useful, but simply prioritizing financial conversations and sharing cost information of any kind can help patients understand their out-of-pocket obligations and plan for any fees they may need to cover be- fore, during, and after surgery. For many patients, the total cost of their surgery care will in- volve a mix of fees covered by insurance and bills they will need to pay out of pocket. Health insurance policies are often complicated, and many patients may be reluctant to admit they don't fully understand their coverage. It may be a relief to have someone walk them through the process and help them better understand who is providing care, their affiliations and network status, and any associated costs, as well as what this all means in terms of deductibles, co-pays and other obligations. In turn, this can mean faster payment for your ASC, streamlined A/R, and increased patient satisfaction. More options to manage balance billing In some situations, due to the nature of their procedure, insur- ance coverage details, or other factors, billing and collecting post-surgery balances is required. Given that 70 percent of pa- tients say they are confused by medical bills, receiving a post- surgery invoice—especially one that may be unexpected, or larger than anticipated—can be problematic. 1 In turn, ASCs and other healthcare professionals may struggle to collect full pay- ment in a timely fashion. According to one survey, 77 percent say it takes a month or more to collect any payment. 1 Between claims submissions, denials, billing and collecting payments, it can take a substantial amount of time to see revenue. On top of these administrative variables, patient needs, preferences and expectations can make it hard to create a process or system that meets both business and patient needs. In addition to helping patients understand and anticipate their 1 InstaMed Trends in Healthcare Payments Ninth Annual Report: 2018, Published April 2019

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