With the focus on healthcare consumerization and rise in patient financial responsibilities, healthcare providers are forced to do more with less. In addition to concentrating on deliver high-quality healthcare services to patients, they are forced assign much of their time on managing patient collections.

What is the exact reason for this? Let’s dig deep and understand the core reason for this shift by comparing the old reimbursement model with the new one.

Old Reimbursement Model

In the past, individual practices and hospitals followed a straight fee-for-service model and typically depended on private insurers or government programs such as Medicare to receive their reimbursements. Patients were nowhere to be seen in the picture.

The biggest benefit of following this model is that providers could always count on steady stream of revenues, which gave room for their business staff to manoeuvre and plan accordingly.

The New Reimbursement Model

Fast forward a few years and the scenario has completely changed. With transition from fee-for-service to value-based reimbursements there is greater emphasize on quality of care and there is also higher patient payment responsibility. Under the new scheme, healthcare practices are being paid for providing better care and there will be no rewards for carrying out unnecessary treatments or procedures, for example. The reimbursements are calculated in part by carefully analysing patients’ opinions regarding the quality of care that they receive from the provider. Also, lower reimbursements to the provider has given rise to higher payment responsibility for patients.

The Impact of New Reimbursement Model on Your Practice

Thanks to the new reimbursement model, millions of patient-owed balances are left on the table, with many practices collecting as little as $15.77 for every $100 that is owed once patient accounts are sent to collections. As a result of this, collecting patients’ owed balances has climbed to become one of the top ten pain points as per 96% of medical practitioners.

From all this, it is very clear that every healthcare practice needs to reassess and come up with modern strategies for billing and collecting patient payments.

A Culture Shift: The First Step towards Successful Billing and Collection

Yes, the core focus of your practice is to maintain your patients’ well-being, but you can’t ignore the financial well-being of your practice. And survivability of your practice over the next few years may depend on how seriously you take up this issue.

Medical providers and staffers alike need to be well acquainted with every minute details associated with how the collection of unpaid balances affects the financial well-being of your practice. Painting a clear picture of how faster payments are connected with the security of their own jobs should be sufficient motivation for the staff to be more vigilant.

Once you achieve this you can move on to implement other industry best practices that are mentioned below and drastically improve your patient collection percentages.

Five Best Practices to Improve Your Patient Payment Collections

1. Train Staff to Efficiently Handle Payment discussions with Patients

Staff should handle every patient interaction with compassion and professionalism. The idea here is to have a conversation and not a confrontation. Patients are already under tremendous stress owning to their medical condition and you shouldn’t make it worse by being harsh.

Show courtesy and let the patients know that your practice understands their financial burdens, and then carefully pilot the conversation towards discussion of various payment options.

2. Improve Communications with Patients

“As per a recent survey, nearly 50% of patients do not understand their medical costs and are more likely to judge the providers negatively because of it”. The only way out of this situation is to plug the communication gap between the providers and patients.

The best way to start is by using emails and text messages to communicate with the patient, which unfortunately nearly 50% of the healthcare providers are not doing, even though the patients say they want or expect this availability.

You can also opt to create a patient portal, which makes communication much easier, using your EHR software. This way patients can send in their queries safely and securely via online messaging, without the hassle of having to wait on hold over the phone. Also, since the staff can respond to the queries at their convenience, the communication will be more streamlined.

3. Collect Payments While Patient Is Still On-site

As per experts, one of the easiest ways to increase patient collection percentages is by collecting the dues while they are at your premises.

Hence start by implementing a policy of collecting co-pays when patients check in. You can also designate a staff member to follow-up on the patients and ensure that the balances are collected before they leave the office.

Yes, motivating staff to carry out this process can be an issue, but that doesn’t mean that you can’t overcome this hurdle. Offering incentives such as commissions or extra time off are sure shot ways through which you motivate staff members to engage patients about payment dues while they are still in the premises.

4. Give Access to Multiple Payment Options

Diversify your patient collection options. After all, more than 70% of consumers in the US use at least three different methods to pay their bills each month.

Since your patients are used to leveraging multiple options to pay, not having them is counter-productive.

5. Take Advantage of Payment Technologies

Companies across industries have made it a practice to send out billing information by email, and you should be prepared to adopt this best practice too by forwarding electronic statements to patients as soon as they leave your premises. And if the payment is not made within due date, you can send gentle payment reminders via the same channel.

For greater convenience, you can also opt to set up card-on-file payment option for each patient and leverage the benefits of scheduled and flexible automatic credit/debit card payments. This kind of automatic payment options will go a long way in reducing friction and help the patients to have a better healthcare experience, which is very crucial in the value-based world.

Conclusion: Collect Sooner, Collect More

In the past, your practice received most of the reimbursements through a business-to-business relationship between providers and insurers, leaving patients largely out of the loop. But things have went for a spin in recent times. Presently and in the future, reimbursements will be a business-to-consumer relationship where collecting more patient payments with minimal or no delays should be your main goal.


Clean Claims On First Submission




HIPAA Compliance


Increase in Collections

Get a Quick Quote

Our Software Expertise

Software Tools We Use for Medical Billing and Coding Solutions