The Executive Suite: Financial success for specialty medical groups depends on a strong back-end approach

Specialty groups like physical therapy organizations are feeling the pinch of higher expenses due to inflation and increased labor costs—and it’s a challenge that will limit growth in provider profits, McKinsey projects.

It’s one reason why the approach medical groups take to post-service financial engagement is critical to their short-term and long-term health.

Some specialty groups already face unique challenges when it comes to patient financial engagement due to the number of claims they process on behalf of patients. For instance, when a single patient receives care multiple times a week—common among patients with chronic and complex conditions—each visit constitutes one claim. Imagine what happens when a patient receives multiple billing statements, each with a different balance. Suddenly, navigating the cost of care becomes confusing, increasing the risk that patients will either delay payment or simply choose not to pay it at all.

Leading groups look for ways to eliminate confusion not just on the front end, when transparency and communication around options for payment are key, but also on the back end, when the quality and even cadence of outreach and the range of patient payment options available makes a significant difference in financial performance.

Making the right moves for financial health

At Central Nebraska Rehab Services, a 16+ location physical, occupational, and speech therapy group, taking a proactive approach to patient payment engagement incorporates digital-first communication and tightly coordinated messaging among staff. It’s a strategy that has enabled Central Nebraska Rehab to collect over half of electronic payments within the first 14 days of bill notification. It has also decreased inbound calls, giving staff more time to focus on denial prevention and management.

There are four lessons learned that specialty groups could incorporate to strengthen revenue while protecting the patient experience.

Adopt a text-to-pay approach to improve cash flow with better patient engagement and convenience. When insurance pays its portion for care, a billing system will show a patient balance right away. However, it may take three weeks or more for a patient statement to be mailed via traditional paper statements. Add to that the time it takes the patient to pay the amount due and it’s easy to see how cash flow can be strangled by traditional paper-based processes. It’s one reason why text-to-pay is a powerful tool for specialty groups—at Central Nebraska Rehab we utilize PatientPay. A text is sent as soon as the patient balance is generated, and the corresponding payment could be executed within a couple minutes, not four to eight weeks later. A digital-first solution like this means specialty groups see immediate cash in their bank, rather than being dependent on slow payments that are mailed. For any size group today, faster cash flow is critical to financial health.
Pro tip: Make sure the secure link sends patients directly to their bill with all of the details included, such as insurance and office payments made to date. The convenience of digital payment becomes lost if a patient must remember their patient portal username and password to access their account, where they not only must determine where to pay their bill, but also don’t have the key details needed to fully understand it.
Educate staff—from front-office staff to therapists—on the move to digital offerings, including text-to-pay and email. At Central Nebraska Rehab, for example, therapists hold a position of trust with patients due to the amount of time they spend together on care—sometimes a few days a week. It’s natural, then, that patients might ask their therapist questions about new digital payment offerings, from text-to-pay to the ability to enroll in a payment plan online from the privacy of home. By combining staff education with marketing of digital offerings, such as information in billing statements a month before go-live, office signage and website messaging, specialty groups can anticipate patients’ questions and help them feel more comfortable from the start.
Pro tip: In multi-specialty clinics, make sure the branding of each group, including the logo, is clearly presented in all communications and on patient bills to avoid confusion.
Make sure patients see new balances first. When patients with chronic or complex conditions see their provider multiple times a week, such as for therapy, their balance continually changes. This can make it difficult—and frustrating—to stay on top of what they owe. By ensuring the order of out-of-pocket amounts due starts with the most recent date of service, patients can gain a clearer view of which claims have been processed, how much they owe, and which appointments and services have been paid for to date. This decreases the potential for confusion while giving patients greater confidence that they can manage their account.
Pro tip: Offer the patient the ability to pay the full amount now or at a later date and to enroll in a payment plan. This reduces inbound calls by presenting all the options up front. At Central Nebraska Rehab, the combination of digital payment offerings and support helps the organization collect 40% of electronic payments within the first eight days of bill notification, before a paper statement drops, reducing mail time and costs.
Offer self-service options for account management—including the ability to self-enroll in payment plans. When patients feel in control of their payment experience, they are more likely to manage the cost of their care in a timely way. At Central Nebraska Rehab, patients can self-enroll in a payment plan directly through the text-to-pay solution. From there, text reminders let them know three days in advance of when monthly payments are processed. These types of reminders help keep payment plan failures to a minimum.Self-service options such as this decrease administrative work for staff. They also contribute to a boost in online payments. Today, over 80% of card payments made by Central Nebraska Rehab patients are completed without involving office staff.
Self-service payment plans have been a big win for Central Nebraska Rehab and its patients. Before incorporating this option, patients might make a single low payment every month or so, which not only took longer to pay off their balance, but increased administrative burden/cost. Now, patients set up larger payment amounts on their own, and they gain the ability to manage their account at any time of day.
Pro tip: Offer flexibility in payment plan terms, such as a tiered system based on the balance due, and find a solution that understands the billing. For instance, Central Nebraska Rehab leverages a “lifetime” bill, where the patient really only has one active bill at a time. Its patient billing and payment system automatically recognizes the bill and assures that current and past services are combined.

A prescription for better financial health

The financial pressures some specialty groups experienced last year aren’t likely to ease up this year, given rising expenses and workforce shortages, McKinsey projects. By taking a proactive approach to post-service patient financial engagement, specialty groups can empower patients to manage their cost of care in ways that meet their needs while protecting their organization’s bottom line.