How to Embrace E-payment with Caring and Compassion

Healthcare consultant Susan Childs, FACMPE, feels that healthcare is unlike other industries in that it has to “balance checkbooks and compassion.”

Fortunately, it's possible to blend these duties with an electronic payment system that promotes prompt and efficient reimbursement, said Childs, who presented at the Medical Group Management Association (MGMA) Annual Conference in Anaheim, Calif., on October 10.

"My priority is access for the patient and for the physician to be paid," said Childs, president of Rougemont, North Carolina-based Evolution Healthcare Consulting. "They're happier patients if they can concentrate on the care instead of the money. It's just a win-win situation for everybody."

The landscape has changed in recent years as the number of patients with high-deductible plans has grown. "They're essentially self-pay, so we need to guarantee their payment sooner and get it paid quicker," she said.

One of the easiest ways to coax patients into paying their existing bills is to always ask for payment at check-in, Childs said. According to her, it's crucial to make a payment request part of that routine. 

"Ninety-four percent of patients expect their next experience to be based on the last one," she said. "If they didn't have to pay before, they aren't expecting this time either. If you don't collect money at the check-in, you just told them it's OK not to pay."

Childs also provided these additional eight tips:

• Understand the benefits of e-payment, like the ability to reach people via stable e-mail addresses instead of physical addresses. "People do not change their e-mail addresses as often as their regular geographic addresses," she said. "It's easier to track your patients with e-mail than it is with an actual address."

• Make sure patients understand the cost of treatment plans. "The more they know ahead of time, the more they are likely to pay the bill. If we envision doing something, the probability of it happening is bigger."

• Don't give patients too much initial time to pay via an e-payment system. About three weeks is a good general guideline, Childs says, about the same amount of time it takes to get an Explanation of Benefits.

• Consider an auto-pay system. She pointed to a doctor who files away patient credit card information and lets bills go unpaid for up to 60 days. "If they don't pay in 60 days, he just charges the credit card," she said. "They cannot come back and say, 'You didn't give me time.'"

• Get signatures from patients who are on payment plans. "If they don't sign anything," she said, "they'll never take it seriously."

• Consider getting a second credit card number when you ask to put one on file. A member of the audience during the MGMA presentation mentioned that about 25 percent of credit cards on file at her practice are declined. Childs recommended asking for a second credit card number as a backup, telling the patient that it's needed "in case the first one doesn't go through."

"Then," she said, "they have to remember to cancel both credit cards."

• Devote a separate room to financial discussions. The room doesn't need to be fancy, Childs said, it must be private and "not behind the [plant] in the lobby."

"The more intense the color, the more intense the feeling," she said. "Paint it light blue or light green, something very calming. Put in a live plant, a picture, something familial. Do not make it look like a prison cell."

• Finally, keep in touch with the doctors whose patients have trouble paying. "Always remember," she said, "that there may be something the physician knows that we may not know."