7 Tips for More Effective Self-Pay Payments Management


As healthcare costs rise, more patients are shouldering increased self-pay responsibility, including higher deductibles, premiums, and copays. This rise in the number of self-pay payments has become a major concern for providers and physicians as self-pay patients default at a rate of 30% or more. Optimizing your revenue cycle management to include a more strategic, proactive focus on addressing self-pay payments can help reduce your overall bad debt and reduce costs associated with collections or write offs. Here’s seven tips to get you started:

  1. Focus on pre-service initiatives

Pre-service is the easiest and most cost-effective time to collect patient information and identify alternative payment sources. Always verify patient information upon check-in. Even if information was verified when scheduling the appointment, patient information changes rapidly. Without the proper information in your system, payment follow-up becomes much more difficult and costly to manage.

Asking the right questions in the pre-registration process can help you screen for patients eligible for charity care, which many patients don’t know about. Investments in eligibility verification can help further identify insurance coverage like Medicaid and Medicare that patients may not be aware they qualify for, reducing their self-pay balance.

  1. Revisit your patient communications

Revising your patient communications—both service and bill reminders—so they’re easier for patients to understand the charges and when payment is due can increase the likelihood of payment. Keep in mind: there have been nearly 20 million people newly insured since 2010. Many of these have had limited access to healthcare previously, so they’re unfamiliar with the terminology and payment process. 

  1. Consider billing and payment consolidation

When applicable for their facility, more providers are offering consolidated bills that capture services performed by the lab, the physician, and the hospital on one statement. Giving all service and payment info at once increases understanding of what’s owed and makes repayment easier for patients and their families to track and budget for.

  1. Take a page from the retail industry

Retailers are highly consumer-focused, bringing in technologies and processes that consumers crave and appreciate. Healthcare providers can do the same. Accepting online payments makes repayment more convenient than trying to find their checkbook and a stamp. Giving patients online portals where they can access all their lab, physician, and hospital records—as well as their statements and payment history—in one place can make the self-pay patient feel more empowered. 

  1. Make pre-service estimates a priority

Nine in ten consumers want to know payment responsibility upfront. Medical costs can often surprise patients, especially as costs to serve and insurance eligibility fluctuates. To bolster the effectiveness, you can also offer the patient a payment schedule in advance with the estimate. When they know what they’ll be expected to pay and when, the patient can plan ahead and ensure they have the proper funds available when the bill comes due.

  1. Look into service deposits

If you make the switch to pre-service estimates, you may also want to consider a deposit program. Requiring a 25-50% deposit before point-of-service encourages patients to keep their appointments and lessens the repayment burden afterwards. It can also help offset the financial strain your practice feels when 100% of the bill goes unpaid.

  1. Send past due accounts to collections

Recovering self-pay balances without tarnishing the patient relationship requires specific expertise most billing departments don’t have. Collection agencies are trained to identify alternative sources for payment and can dedicate the time to educating the patient on their bill, increasing the likelihood of payment to your facility next time. By outsourcing self-pay collections early (0-90 days), the collection agency can reach out to the patient in your name (commonly called first-party recovery) for a soft-touch collections call.

Managing your self-pay payments boils down to better communication and more proactive engagement with your patients. The easier you can make the repayment process and the clearer you can be when notifying patients of services and costs will help increase the likelihood of on-time repayment.

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