Implementing a Robust Pre-Visit Process: Essential Strategies for Strengthening the Revenue Cycle

Implementing a successful pre-visit process is a crucial yet often overlooked component of revenue cycle management. In an era where patient financial responsibility continues to rise, establishing an efficient pre-visit process offers several benefits. It helps manage patient expectations, enhances satisfaction, and reduces bad debt. The pre-visit process is about more than just insurance verification; it’s about proactive communication and providing patients with financial transparency and options. Let’s dive deeper into the various elements that make this process effective, with examples and practical applications that healthcare providers can adopt to improve both patient experience and financial outcomes.

Why a Pre-Visit Process is Essential

Over the past decade, high-deductible health plans have shifted more financial responsibility onto patients. The result? A rising volume of patient bad debt, which healthcare providers are struggling to collect. According to recent studies, nearly 70% of patients find it challenging to pay medical bills without assistance. This trend makes it clear: having a reliable pre-visit process to communicate financial responsibilities is vital.

Yet, the benefits go beyond financial security for providers. A well-executed pre-visit process also improves patient satisfaction by eliminating unexpected billing surprises, which often lead to frustration and, ultimately, nonpayment.

Key Components of the Pre-Visit Process

To build an effective pre-visit process, healthcare organizations must integrate several key elements that contribute to a positive patient experience and streamline financial clearance.

1. Transparent Financial Estimations and Explanations

Traditionally, pre-visit preparations involved verifying insurance coverage, benefits eligibility, and patient financial responsibility. Today, this scope has expanded to include transparent communication of the patient's expected financial obligations.

Providing patients with clear estimates before their visit helps them understand what they owe and why, which reduces confusion and fosters trust. Recent surveys reveal that 43% of patients fully understood their bills, but a significant percentage (33%) still struggled with comprehension. Providing a simplified, upfront breakdown of estimated costs can reduce misunderstandings.

For example, if a patient is scheduled for surgery, they should receive a detailed estimate of their financial responsibility, including unmet deductibles and co-pays. This proactive communication can be complemented by easy-to-read billing summaries, online cost calculators, or discussions with billing staff for further clarity. A healthcare system in New York saw a 20% decrease in collection times after they began providing detailed financial estimates before appointments, paired with clear explanations of insurance coverage and out-of-pocket costs.

2. Effective Communication and Financial Transparency

Patients are increasingly frustrated by unclear and inconsistent communication about their healthcare expenses. According to patient feedback, 46% would find it easier to understand their bills if providers offered upfront explanations regarding insurance coverage and expected costs. Not only does clear communication increase patient satisfaction, but it also empowers patients to be more proactive about their healthcare.

Take our client for example, an illustrious Midwest health network that faced significant challenges with patient satisfaction due to surprise medical bills. We implemented a pre-visit process where patients receive an estimated out-of-pocket cost and an itemized explanation of benefits before their visit. This initiative resulted in a 15% increase in patient satisfaction scores, with patients appreciating the transparency and being better prepared to manage their payments.

3. Offering Multiple Payment Options

The success of a pre-visit process depends on giving patients convenient ways to settle their financial responsibilities. Research shows that 81% of patients are more likely to pursue care if they understand costs upfront and have flexible payment options. Providers can enhance the pre-visit process by offering payment plans, financial assistance programs, and options like “text-to-pay”.

Take our client for example, a renowned California-based health system looking for ways to streamline its collections, introduced an online portal where patients could review their bills, choose payment plans, and set up automatic payments. This system, introduced as part of the pre-visit process, saw an 18% increase in on-time payments and reduced administrative costs related to collections.

4. Financial Assistance Programs

Not all patients are capable of bearing the full brunt of their financial obligations. For patients experiencing financial hardship, offering discounts or enrolling them in financial assistance programs is crucial. Being proactive about offering help builds goodwill and increases the likelihood of payment.

A case study from a Southern hospital system highlights this point. By identifying patients eligible for financial assistance early in the pre-visit process, they not only helped patients avoid debt but also improved cash flow and reduced bad debt. Patients in these programs also expressed higher levels of satisfaction with the care received, despite their financial limitations.

5. Simplifying Collections with Patient-Friendly Terminology

Shifting collections to a pre-service basis and reframing the terminology can have a significant impact on patient experience. Instead of "collectors," healthcare organizations can refer to these team members as “financial advocates.” This change in title not only fosters a patient-friendly atmosphere but also signals to patients that their financial well-being is being considered.

For example, one healthcare provider restructured its collections process by training financial advocates to assist patients in understanding their financial responsibilities. As a result, they saw a 25% increase in collections, primarily because patients felt they were being guided rather than pressured to pay.

6. Collaboration Between Teams for Efficient Collection Efforts

Combining the efforts of the business office and scheduling team can help in efficiently collecting payments. Traditionally, business offices reach out to patients to discuss outstanding balances, while the scheduling team handles appointment logistics. Training schedulers to request payments during scheduling or check-in can streamline the process.

A healthcare facility in Texas employed this strategy, training schedulers to mention outstanding balances when confirming appointments. By doing so, they noticed a 17% increase in pre-visit collections, reducing the need for follow-ups and improving patient compliance with payment expectations.

7. Using Technology to Facilitate Pre-Visit Processes

Adopting technology solutions to automate parts of the pre-visit process can significantly improve efficiency. Tools such as electronic health record (EHR) systems integrated with billing software will automatically generate patient estimates, verify insurance in real time, and send automated payment reminders. Some providers use secure portals that allow patients to review their financial responsibilities and make payments before their visit, adding another layer of convenience.

For example, a case study of our client, an Illinois-based health system demonstrated the effectiveness of this approach. After implementing an automated pre-visit process, they saw a 30% decrease in administrative workload and a 40% increase in patient engagement, as patients felt more informed and financially prepared for their care.

In Conclusion

A robust pre-visit process is no longer a luxury; it's a necessity in today’s healthcare landscape. By proactively addressing financial concerns, providers not only increase the likelihood of timely payments but also enhance the patient experience, fostering a positive and trusting relationship. From transparent cost estimates to convenient payment options and patient-friendly collections, implementing a thoughtful and efficient pre-visit process sets the foundation for better financial health—for both the provider and the patient.

Bill on Time, Get Paid on Time

At Bristol Healthcare, we understand the importance of collecting every dollar and billing patients on time. Our services are designed to help practices accelerate cash flow, optimize the collections process, and enhance patient satisfaction rates. Click the link to learn more about our patient billing and statement services (or) schedule a free consultation to learn more about how we can assist your health system.