Why Are Healthcare Systems Not Getting Paid, and What Can Your Practice Do About It? 

Updated on February 7, 2023

In 2021, patient financial responsibility reached a net total of $491 billion, and in 2023 we anticipate this number continuing to grow. This means that your practice’s financial health heavily relies on patients paying their medical bills quickly and in full. Yet, 19% of American households could not afford to pay for medical care they received right away, according to U.S. Census Bureau data. And households with children are more likely than those without children to have unpaid medical bills. These unpaid balances impact your practice’s bottom line. To help your practice get paid more, faster, it is important to understand the top reasons impacting patient payments. 

Shifting payment responsibility 

Insurance policy pricing and employer-sponsored health plans have changed, resulting in many individuals shifting to high deductible health plans (HDHPs). These insurance plans often come with lower premiums but require patients to foot a significant portion of the healthcare costs – sometimes upward of $5,000 annually. This growing trend is here to stay and is putting individuals under more stress to pay their bills on time and in full, and in turn creates challenges for healthcare practices to capture payments. 

Fragmented billing

Currently, medical treatment is billed separately for each portion of care and by the types of services rendered. In specialty practices, fragmented billing isn’t as significant of a struggle. However, for larger healthcare practices that offer extensive procedures such as open-heart surgery, patients can receive individual bills for each step of care along the way, including separate bills from the cardiologist, surgeon, lab, anesthesiologist, consulting doctor and more. This contributes to missed medical payments as patients are often confused about what payments they owe and how to pay them. 

Confusing billing or payment process

Healthcare providers often address patient collections after an appointment. These payment notifications have traditionally been delivered through standard mail and typically require some effort on the patient’s part such as calling the office for payment details, logging onto a website to enter account information or making a payment by mail. Many paper bills get lost in a pile and require billing staff to follow up by phone or with additional mailed reminders.  

Errors in manual data entry

Many healthcare practices still rely on paper forms and manual entry to capture and track payment information, which opens the door for errors around billing information as well as inaccurate addresses for delivering statements. 

Modern patient payment solutions can help practices overcome these common collection challenges by improving the communication process and simplifying the payment process for patients and staff alike. However, not all solutions are the same. When selecting the right option for your facility, here are three key features to look for:

  • Payment terminal: Some digital payment solutions offer state-of-the-art payment terminals to help practices capture all costs, including outstanding balances at the time of service. These terminals can simplify the payment process for patients with a one-click, secure in-office solution. Some can even retain a card on file or offer features like Apple Pay and Google Pay, making it more convenient for patients to pay using their preferred method of choice.  
  • Multiple communication options: Traditionally, practices have relied on paper statements delivered via standard mail. However, 44% of patients pay medical bills faster when they receive digital or phone notifications about billing, and 49% would pay by text if available. Finding a solution that supports text, email and paper mail options, as well as automated follow ups, can ensure that patients are receiving the information in a format that works for them. 
  • HIPAA compliant: Choosing a system that is created specifically for healthcare can ensure you are compliant with the Health Insurance Portability and Accountability Act (HIPAA). This can include having secure log-in for all staff, safeguards against potential hacks and more.
  • PCI compliant:  When moving to a digital payment solution it is important to verify that your new solution is PCI compliant(Payment Card Industry Data Security Standard compliance) to ensure patient credit card data is secure and does not fall into the wrong hands.

Collecting payments is critical to running a successful practice. While many of the challenges patients face won’t disappear this year, making the process easier can improve their experience overall and ensure longevity in the relationship. Additionally, gathering payments in full improves the revenue collection for practices and eases the burden on staff. Modern payment technology is helping practices improve their bottom line. 

d’Artagnan Osborne

d’Artagnan Osborne is the general manager of payment solutions at Kareo, a Tebra company. Tebra was formed in 2021 and provides an all-in-one practice success platform to build the independent healthcare practices of the future. Tebra is the digital backbone of a practice’s success and features Kareo Patient Collect, an automated, consumer-centric, unified patient payments solution resulting in happier patients and greater, faster revenue.