The patient financial journey refers to the entire process of billing and payment that patients go through when receiving healthcare services.
From the initial consultation to the final bill, there are many steps involved in the patient financial journey, and each step can have a significant impact on patient satisfaction and healthcare provider revenue.
Here are some of the key steps in the patient financial journey:
Pre-Service
The pre-service phase begins before the patient even sets foot in the healthcare facility. It includes the initial appointment scheduling, insurance verification, and eligibility verification. This is the stage where patients typically provide their insurance information, and providers verify if the patient's insurance plan is in-network or out-of-network. Providers also check if the patient has any prior authorization requirements.
Point-of-Service
The point-of-service phase occurs when the patient arrives for their appointment. During this phase, providers may collect copays, deductibles, and co-insurance. Providers also have the opportunity to explain billing procedures, and to educate patients on any financial assistance programs they may be eligible for.
Post-Service
The post-service phase includes claims submission and processing, and it's the most complex stage of the patient financial journey. Providers must submit claims to insurance companies, follow up on denied or rejected claims, and resolve any billing disputes. This stage also includes patient billing, where patients receive an explanation of benefits (EOB) and their final bill.
The patient financial journey is not always a smooth one. Patients may experience confusion about their bills, misunderstandings about insurance coverage, or unexpected charges. These can lead to negative patient experiences and increased stress for both patients and providers.
To help streamline the patient financial journey, providers can implement strategies such as:
Improving Communication
One of the most important ways to improve the patient financial journey is by improving communication. Providers can communicate clearly and consistently about billing procedures, insurance coverage, and financial assistance programs. Patients who understand their financial obligations are more likely to feel satisfied with their care.
Streamlining Billing Processes
Providers can streamline billing processes by using electronic health records (EHRs) and automated billing software. These tools can help reduce errors and speed up the claims submission process, making it easier for providers to get paid quickly and accurately.
Offering Payment Options
Providers can also improve the patient financial journey by offering flexible payment options. This can include payment plans, online bill pay, and automatic payment options. These options can help patients manage their healthcare expenses and reduce the risk of overdue bills.