Why Is It So Difficult to Collect Payments from Patients?

If you’re struggling to collect payments from your patients, you’re not alone. Medical practices rely on patient payments to cover various expenses such as staff salaries, equipment maintenance, rent, and supplies. Without adequate and timely payments, medical providers can face financial challenges that can impact their ability to deliver quality care. However, collecting payments from patients can be challenging for various reasons. Medical revenue cycles are notoriously complex, but there are ways your practice can improve your collections processes without creating undue stress on your staff and patients.

Download Our Guide

Many Patients Struggle to Pay Their Bills

Collecting payments from patients is a common challenge faced by medical practices. In fact, unpaid medical bills are a prevalent issue in the healthcare industry. According to a survey by the Kaiser Family Foundation, approximately half of Americans reported difficulty paying for their healthcare services. And when that many people struggle to pay their medical bills, it’s no wonder practices are feeling the effects as well. 

Factors Contributing To The Difficulty Of Collecting Payments From Patients

Collecting payments from patients can be a challenging task for healthcare providers, particularly for physicians who often rely on these payments to sustain their practices. But when patients come to you seeking services, the last thing they should have to worry about is how they’ll pay their bills. In order to increase your collections rate, it’s important to understand the hurdles patients face so you can develop an empathetic, effective solution. Here are three common reasons patients struggle to pay their bills:

Healthcare is Expensive, and Only Getting More Costly

As healthcare costs continue to rise, patients face more significant financial burdens when it comes to paying for medical services. This, in turn, makes it more challenging for physicians to collect full payment for their services. When patients are burdened with high medical bills, they may struggle to make timely payments or may even default on their obligations.

The increasing costs of healthcare can be attributed to several recent industry trends. One major factor is the continuous development and adoption of new technologies and treatments. While these innovations undoubtedly improve patient care, they also come at a cost. The high expenses associated with research, development, and implementation are ultimately passed on to patients, making medical services more expensive.

Another reason for rising healthcare costs is the growing demand for services. As the population ages and chronic conditions become more prevalent, the demand for medical care increases. Medical providers need to invest in additional personnel, equipment, and resources to meet this demand, further driving up costs.

patients and providers in a waiting room

When Insurance Claims Are Denied, Patients Pay the Price

Billing and coding errors can significantly hinder the collection of payments from patients for care. These errors can result in incorrect charges, denials from insurance companies, and delayed reimbursements.

Billing errors occur when there are mistakes in the billing process, such as incorrect patient information, wrong codes used for procedures or services, or missing documentation. These errors can lead to patients being billed for services they did not receive or being charged the wrong amount. When patients receive incorrect bills, they may dispute the charges, causing delays in payment.

Coding errors, on the other hand, occur when the wrong medical codes are used to describe the procedures or services provided. These errors can result in claims being denied by insurance companies or delayed reimbursements. Insurance companies rely on specific codes to determine coverage and reimbursement amounts. If the codes used do not accurately reflect the services rendered, insurance companies may deny the claim or require additional documentation, leading to delays in payment.

To improve payment collection, it is crucial for physicians to review and double-check their billing and coding processes. This includes verifying patient information, accurately documenting services provided, and using the correct codes. Regular training and education for staff on proper billing and coding practices can also help minimize errors and improve payment collection efficiency.

Patients May Not Understand their Bills

Medical billing can be complex and overwhelming, making it difficult for patients to navigate the system. Every practice’s financial statements can look a bit different, and the language medical professionals are familiar with is usually more foreign to patients. When patients don’t understand what they’re expected to pay, it’s much more likely that practices will struggle to collect. 

To address this issue, clear communication and patient education are crucial. Healthcare providers should take the time to explain billing processes to patients, including the details of their statements and the procedures coded on them. By helping patients understand the various codes and charges, they will be better equipped to review and comprehend their bills.

Additionally, healthcare providers can implement strategies such as providing itemized bills, offering online resources explaining common billing terms, and having dedicated staff available to address billing questions. Open and transparent communication channels can build trust and engagement between providers and patients.

Strategies For Improving Patient Payment Collections

Medical practices can adopt several strategies to improve patient payment collection and streamline the payment process — and we’ve developed a guide to walk you through best practices used by our clients. Our billing experts at Benchmark Solutions are dedicated specialists that partner with providers to supplement existing RCM processes. If you’d like to learn more, download our guide, or contact us today.