Optimizing the Patient Bill Lifecycle

Updated on October 1, 2021

By Evan Goad, Vice President and General Manager of Patient Experience, TransUnion Healthcare

Knowing the lifecycle of a patient bill is critical in helping alleviate patient billing concerns, and in helping healthcare providers ensure timely payment. Feeling the burden of higher healthcare costs, patients are taking a proactive approach and educating themselves regarding the financial aspects of their care. 

As the patient portion of healthcare costs rises, so does confusion about the bill. In a recent TransUnion survey, only 52 percent of respondents said they fully understood their financial responsibility for a medical bill. When a patient gets a healthcare bill, they may face confusion regarding their payment responsibility, balance after insurance and timing of payment.

According to the American Hospital Association (AHA), hospitals provided $41.61 billion in uncompensated care in 2019. To ensure long-term success and sustainability, hospitals must optimize their payments from all payers — including the patient. Closely examining the various stages of the patient bill lifecycle gives providers insight into opportunities to provide patients with a clear understanding of costs up front so they can confidently meet their financial responsibilities. 

Smoother payment processes

The full patient bill lifecycle typically begins at scheduling/pre-registration and continues through cash posting. The following key stages below represent various check points and the strategies necessary to help deliver a more seamless payment process for both patient and provider. 

Scheduling/Pre-Registration

Prior to receiving care, patients want a transparent understanding of price and their out-of-pocket cost. A recent TransUnion Healthcare survey showed that 90 percent of Gen Z patients and 87 percent of Millennial patients use healthcare provider or payer/insurance websites to research their costs. Some 47 percent said having clear pricing information impacts their decision to use a healthcare provider.

Patients want to know how much they’re expected to pay, and what financial assistance or payment plan options are available to them before treatment is provided. Healthcare providers should have an easily-accessible, patient-facing estimation tool, enabling those shopping around for a provider to gain a clear, upfront understanding of their costs. 

Registration

Providers need to take the necessary steps to ensure all registration information is right the first time. In fact, TransUnion Healthcare found only 37 percent of payers and 58 percent of providers are very confident that their member/patient contact information is correct.

When it comes to the patient bill lifecycle, accurate registration information prevents rework downstream — ultimately saving time and money. This also helps provide assurance for the patient that their information is correct and any financial assistance available to them has been applied.  

Discharge

After care has been rendered, the best chance of clarifying charges comes at discharge. By providing a clear breakdown of payment responsibility, providers can ensure they have discovered all eligible coverage and verified demographic information. This stage is an opportunity to meet with the patient face-to-face and collaborate on a personalized payment strategy. 

Once the patient has been discharged, it can be more difficult to discuss payment options. That’s why it’s so important to have these conversations in advance and avoid mailing out the bill without doing so. According to the Academy of Healthcare Revenue, “providers have a 70% chance of receiving payment at the time of service if they request it — but only a 30% chance of collecting after a patient leaves the building.” 

Final Bill

When the final bill arrives, it’s often too late for corrections to be made. By conducting the necessary review and analysis to confirm the bill is accurate, providers can avoid costly errors that result in payment delays and disputes.

Implementing a Proactive Patient Payment Plan

The importance of understanding healthcare costs is clear. According to TransUnion Healthcare, when given an estimate at the time of service, 60 percent of patients said they’d be more willing to make at least a partial payment. As consumerism continues to advance in healthcare, providers should implement patient payment plans to help manage the lifecycle of a patient bill.

Being proactive with a comprehensive patient payment experience will prevent revenue-capture opportunities from slipping away. It will also enhance the overall patient experience and encourage more timely payment. A true win-win for the patient and the provider.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.