Loyale Healthcare, LLC, a Leading Firm in Healthcare Financial Services, Provides Insight on Rising Healthcare Costs and Impacts on Patient Satisfaction

Share Article

Healthcare Providers Can Increase Cash Flow, Patient Satisfaction through Technology Improvements

Turning Patient Responsibility into Lasting Loyalty

There are several steps that a healthcare provider can take to significantly increase the amount and timing of cash collections from patients and at the same time increase patient satisfaction - Kevin Fleming, Loyale Healthcare CEO

The rising cost of healthcare services and the corresponding cost of healthcare insurance represent significant economic issues for employers. Additionally, these higher costs are proving to be a barrier to patient treatment. Further inhibiting access to care, some providers are requiring upfront deductible payments from patients before they will admit them.

Too often, the patient does not have the required funds to meet their deductible or the provider admits the patient and is not able to collect the deductible resulting in “lost money.” With the emergence of HDHP plans and increasingly higher deductibles, a financial solution needs to be created to assure that patients have the ability to meet their out-of-pocket obligations on terms they can afford, thereby assuring the provider that they will receive a fair fee that is not diluted by uncollectible deductibles (bad debt).

Background: Growth of Healthcare and Insurance Costs

Most covered workers face additional out-of-pocket costs when they use health care services. Eighty percent of covered workers have a general annual deductible for single coverage that must be met before most services are reimbursed by the plan. Even workers without a general annual deductible often face other types of cost sharing when they use services, such as copayments or coinsurance for office visits and hospitalizations.

In 2017, the average annual premium for employer-sponsored health insurance was $6,690 for single coverage and $18,764 for family coverage, increases of 4% and 3% respectively. Longer term, however, the percentage of covered workers with a general annual deductible of $1,000 or more for single coverage has grown substantially, increasing from 34% in 2012 to 51% in 2017 according to the Kaiser Family Foundation.

For many healthcare providers, collecting the patient deductible and patient billings on a timely basis is a significant challenge resulting in escalating costs due to uncollectible billings and patient relationship issues. Efforts to collect are often a delicate balance between maintaining good patient relationships and successfully communicating that providers' costs must be met to maintain the required level of care, if not their very survival.

Most industries have an advantage over traditional healthcare providers in that payment is received by the seller before delivery of the goods or services. In addition to traditional forms of payment, such as cash, checks and credit cards, digital fund transfer services like Paypal and other electronic payment methods are accessed and approved before the transaction is completed. Healthcare providers, large and small, have generally been slow to adapt to the movement to electronic payments and to employ strategies to improve their Cash Collection Cycle, the time between when a service is rendered and when payment is received.

There are several steps that a healthcare provider can take to significantly increase the amount and timing of cash collections from patients and at the same time increase patient satisfaction. In essence, embracing newly developed technologies and strategies in patient “order to cash” processes, healthcare providers can emulate the payment efficiencies of traditional and Internet based businesses.

The High Cost of a Bad System

Providers that bill patients for services when or after the healthcare service is performed need to have great systems for cash collection follow-up. Poor cash collection systems can result in:

  • High billing error rates – Were the proper terms and payment agreements completed when the patient checked in?
  • High error rates – Were all of the services quoted to the patient? Frequently, the patient never sees the total detailed billing to the health insurer or Medicare.
  • High DSO (Days Sales Outstanding) rates – As healthcare providers, act as their own “bank,” self- financing services and getting paid long after the service is rendered.
  • High cost of dispute resolutions – Failure to effectively manage patient relationships with financial necessities when it comes to collecting cash from a patient.
  • Inefficient/ineffective collection processes – Poor performance of patient balances as measured by bad debt, cost of collections, potential harm to relationships or reputation when using third parties.

The result of a poor patient billing and collection system is long-term losses due to market share loss as patients choose providers offering better perceived value. And because concerns about the cost of care often precede the administration of care - and the billing process proceeds well beyond treatment, patients’ financial experiences are among the most memorable and impactful of their overall experience. If those experiences are poor, their entire experience is degraded.

Addressing Slow Paying Patients

Let’s assume that your billing and collection systems and processes are just fine but you still have too many slow paying patients.

Where do you start? Here are some thoughts:

  • Start by looking at how to streamline internal processes and making it easier for patients to work with you – Is it easy to work with you financially as a healthcare provider?
  • Know and understand your current and prospective patients and their cash flow business to help reduce non-payment risk and tailor collections strategies.
  • Communication with your patients is key to efficiency and visibility into their financial condition can help you tailor payment cash flows that will be manageable for the patient. Many patients tell stories of the heart stopping shock of six figure bills for service when they were expecting a much lower bill.

Strategies to Collect Cash

Consider doing business with your hospital from a patient’s perspective. Are you as efficient in handling the financial part of the patient services as you are with the quality of other services?


  • Implementing or expanding automation of the Order-to-Cash (O2C) cycle (Quote/Order to Cash (O2C) normally refers to the Enterprise Resource Planning (ERP) process in which encompasses taking patient requests for services then providing the service and then generating an patient invoice and collecting payment for that invoice).
  • Standardize your procedures for patient service quotation and order management.
  • Integrate order entry, credit, billing, and collections.
  • Investigate benefits of event management and automated alerts.
  • Centralize patient risk information in a single location.

Embrace Technology

Much of the consumer sector has moved to electronic bill pay from paper checks and this trend will continue. However, many healthcare providers have been slow to embrace electronic payment processes. Hospitals and other providers should be able to accelerate patient payments by incorporating technology into patient collection processes. Below are some key steps in the patient financial management process that can increase cash flow and increase patient satisfaction:

Together with the patient, create a Custom Patient Financial Plan: A “living” electronic agreement summarizing each patient’s financial responsibility, and the plan and progress for meeting it.

Streamline your Patient Registration Process: Integrated state-of-the-art patient registration that allows patients to bypass the dreaded “clip board” and provide their information at home and in advance.

Incorporate a Patient Financial Assessment into the registration process: A non-intrusive financial assessment of the patient’s financial circumstances to inform both provider and patient options.

Incorporate Estimated Patient Share financial tools into the patient financial management process:     A collection of estimating tools that combine insurance and deductible information with treatments costs to realistically estimate the patient’s most likely financial responsibility.

Provide Patient Financing Options: All patients are not alike and one size fits does not fit all. A comprehensive, integrated set of patient financing resources, including payment plans, 3rd party financing, charity assessment and incentives to fairly and realistically support access and treatment.

Create custom, Patient-Focused Communications and Payment Options: On site, online and mobile-enabled patient communication and payment channels to provide current financial status, updates, and history in secure, patient-friendly formats.

Healthcare is a service but also a business. Managing your cash flow is critical to the cost of service but also a component of patient satisfaction in terms of customized payment plans to fit your patient needs.

Kevin Fleming is the CEO of Loyale Healthcare, LLC based in Lafayette, California.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Michael Morrison
Visit website