When Patients Pay the Bill for High-Cost Services: Navigating Patient Financial Engagement 

Updated on November 17, 2023
Healthcare costs and fees concept.Hand of smart doctor used a calculator for medical costs in modern hospital with VR icon diagram

At a time when nearly 40% of consumers have cut back on necessities to pay for medical care, the pressures of keeping up with care costs increase when patients needs specialty services. It’s a scenario that is prompting many providers to reexamine their approach to patient financial care.

The financial burden consumers carry for care extends beyond increased premiums and deductibles. For instance, the financial cost of fertility services can reach six figures, depending on the types of procedures a patient undergoes and for how long. This doesn’t include the cost of time off work, when needed. And while insurance may cover a portion of the care received, the individual cost burden could still hold a heavy weight.

Then there are services like physical therapy and rehabilitation, which generally require continuous sessions of treatment—sometimes two to three times a week. When patients haven’t yet met their deductible for the year, the out-of-pocket amount due can add up quickly. And while this can pose a challenge at any time of year, it’s especially daunting to manage an expense like this during or after the holiday season, when the “spirit of spending” could result in $1,652 in holiday shopping expenses per consumer.

These are just some of the reasons why an effective post-care approach to patient financial engagement is crucial.

Handling High-Cost Services with Care

Certainly, preservice conversations about out-of-pocket costs of care are an industry best practice. Not only do such conversations eliminate the potential for surprise, but they also offer an opportunity for staff to present options for payment and help patients establish a plan to cover the cost of their care. For services like physical therapy, where coverage has declined considerably in the past five years, a preservice plan of attack preemptively eases the stress of care.

But maintaining a warm connection to patients following the encounter matters—especially in keeping patients financially engaged. When statements are sent by mail a month after service is received, it’s easy for people to set them aside with good intentions to pay them later. When life gets in the way—or when other expenses creep in—suddenly, certainty around how to manage medical expenses gives way to doubt. From there, it becomes easy to prioritize other expenses.

Digital approaches to patient financial communications and payment offer a route for reaching patients that provides a sense of immediacy. To optimize engagement for high-cost services, consider the following actions.

Take a text-first approach. The speed and ease of text-based communications enables providers to send financial communications as soon as a bill is generated—typically, after insurance has paid its portion. That’s different from paper statements, which might take three weeks or more to mail. With text, patients gain an immediate view into their out-of-pocket balance at any point in their therapy. That’s critical given the number of therapy sessions an individual might attend during any given week. With this clear view, patients feel more comfortable making a payment—often within minutes. The best text-to-payment communications provide a secure link that sends patients directly to their bill. That’s because the speed and convenience of mobile loses its value when patients have to log onto a portal to view their bill first.

At Integrated Rehabilitation Group (IRG), a 40-location physical therapy group based in the Northwest, text-to-pay communications generate a 65% payment rate, with many payments made as soon as the text is received. With this revenue, IRG has opened new clinics and introduced a variety of new services, like rehabilitation for patients suffering from traumatic brain injuries, concussions, and cognitive challenges.

Give patients a view of new balances first. When patient visits occur more than once a week, their account balance continually changes, making it difficult to stay on top of what they owe. Make sure to separate the balance due by service date, showing the most recent date of service first, so patients can clearly see what has been paid by insurance—and when—as well as the out-of-pocket amount now due. This reduces inbound calls by helping to eliminate confusion. It also gives patients greater confidence that their bill is accurate and ready for them to act upon.

At Central Nebraska Rehab, a 16+-location physical therapy group that provides physical, occupational and speech therapy services, clarity in digital financial communications helps the group collect 56% of electronic payments within the first 14 days of bill notification. This empowers staff to devote greater time to denials prevention and management.

Make sure patients have the tools they need to self-manage their accounts. This includes access to alternative options for payment, such as the ability to enroll in a payment plan when financial circumstances change or the ability to manage multiple copays and a deductible strains an individual’s resources. Text reminders can then be sent to help keep payments on track. At Central Nebraska Rehab, a self-service approach to payment plan enrollment and management contributed to a boost in online payments, with 84% of card payments made without involving staff.

A Consumer-Conscious Communications Approach

Today, nearly one out of three Americans owe money to healthcare providers, whether for routine care for chronic conditions or for new diagnoses or emergency care—and half of these adults owe $2,000 or more. By leveraging digital tools and support to proactively engage patients in their financial responsibility for care, specialty providers can more effectively ease financial stress while protecting their ability to provide the services their communities need.

Tom Furr
Tom Furr
CEO and founder at PatientPay

Tom Furr is CEO and founder of PatientPay.