Self-Pay Revenue Management

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How the billing experience can tarnish a physician’s reputation

October 25, 2018 - 5:08 AM

How the billing experience can tarnish a physician’s reputation

Recently, a friend asked me for help. Her husband was involved in an accident and the mounting medical bill management had become overwhelming. She explained that she had tried to get answers from the hospital billing staff but that she kept getting a different answer. One hospital representative told her that she needed to appeal the claim. Another representative told her that the balance was her and her responsibility and that she needed to set up a payment arrangement while another told her she needed to pay the balance but, that she could give her a bill reduction. I suggested we review her statement and the hospital website. We reviewed her billing statement hoping to get further billing instructions, but the bill offered very little information. We then went to the hospital website hoping to find answers, but the hospital repayment terms were missing, and her billing itemization was confusing. The looming unanswered questions were puzzling and were causing un-needed stress for my friend and her husband.

I wondered after spending time with her whether the physician knew that the service he rendered may have been satisfactory but that the unsatisfactory billing experience may prevent his patient from getting the help he needs. The medical billing process can be emotional for patients. The fear that their credit worthiness will be tarnished evokes anger and frustration. Debt is stressful, especially for a husband who’s been the sole provider for his wife and children. The best choice for this Man is relax and focus on his health. Unfortunately, he may choose to stay out of debt, selflessly protecting his family from further financial distress rather than get additional health treatments. He may speak ill of the healthcare system and provider out of anger for the loss of his financial freedom and declining health. This is the story of just one patient but is representative of a growing concern. A physician’s reputation can be tarnished by a co-worker.

As healthcare grows, technology will continue be utilized and organizations will need strong leadership to help in providing a balance between reputation management and patient experience. Leadership can be leaders in providing a positive experience by implementing new standards.


Organizations have lots of parents. We call them Managers and they all have a different way of parenting/managing. When our Management isn’t aligned we end up with sub-cultures. In order for your organization to provide the same consistent value, you need to change the mindset. Management needs to meet frequently focusing on the mindset, culture, values and goals. You can work with your HR department to implement a “Patient health is top priority” approach and a plan for hiring like-minded individuals. Organizations will work at aligning their values when they enjoy their co-workers.

Patient Communication

Use your existing communication channels to deliver patient billing information. Make pro-active calls to your patients with unpaid balances especially those who had mail returned. Provide soft-skill and emotional intelligent communication training to your billing staff. Communication is tricky when your discussing emotionally sensitive situations. You need your staff to be well trained in communication. Send patient friendly mail and e-mail notifications clearly detailing amounts owed for services. If you have a multi-lingual patient base. Hire multi-lingual representatives. You want to make sure all of your patient population is happy.


Healthcare is full of data! Be good stewards over your data by using it to help you craft smart policies. You can create propensity to pay models from your existing patient payment data to help determine your patient’s ability to repay their balance.


Use your website to display patient policies. Give your patients the ability to manage payment arrangements through your site. This can help you with staffing. If your billing staff is spending the majority of their day handling payment arrangements, re-direct the traffic. If you’re having a hard time getting patients to visit the website. Direct traffic to your website by including a link on your patient statements, text messages, e-mail notifications and interactive voice response systems.

To give patients a better experience, leadership needs to think beyond the patient physician relationship. A patient may experience everyone from the physician to the cafeteria worker. Every person within your organization should be working to support the patient relationship. If everyone works together to improve the experience, your patients will be healthier and happier.

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Written by Acooper32

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