HAP Radiology Billing and Coding Blog

How Patient Consumerism Impacts Today’s Radiology Practice

Posted: By Sandy Coffta on July 05, 2018

How Patient Consumerism Impacts Today’s Radiology Practice Healthcare Administrative PartnersConsumerism in the world of healthcare means that patients are taking a more active interest in the cost and quality of the services they receive.  They have been forced to foot the bill for an ever-larger share of the total cost, and they want to make sure they are receiving the highest quality for their expenditure.  We have written before about the impact of today’s high-deductible health insurance plans, and thus far the slow dissolution of the Affordable Care Act is not causing employers or insurers to back down from those high deductibles. 

 

Radiology practices, and imaging centers in particular, have to address the priorities of the patients to remain successful in this environment.  Studies have shown that cost is the biggest determinant in a patient’s choice of healthcare services, with quality of services coming in second.  Along with cost, convenience is an important factor.  Let’s explore some of the ways your radiology practice can capitalize on these priorities.

Create a positive image

Some healthcare services are non-emergent and are therefore something patients can take the time to shop for.  Routine imaging, such as periodic mammograms, certainly falls into this category.  Patients can take advantage of the internet to shop for availability, pricing and reviews.  Imaging centers that are consumerism-focused will have up-to-date web sites and social media pages with good information for patients.  They will pay attention to the feedback posted, and proactively take the time to post positive testimonials to offset the inevitable negative reviews.  This is the first step toward transparency and good communication, both of which go a long way toward patient satisfaction with the practice – which will translate into enhanced revenue through patient loyalty and better collection of fees. 

Don’t sweep fee collection under the rug – deal with it!

Avoiding discussion with patients about payment is outdated – embracing the topic and helping your patients understand their insurance coverage is the way to succeed in the age of consumerism.  Even when the definitive word on patient costs must come from the insurer, discussing the patient’s coverage, knowing the likely level of insurance payment and the resulting co-insurance or co-payment is good customer service your patients will appreciate, not a task the practice should avoid.

 

Collecting co-payments at the time of service has been recommended for decades, but in today’s environment a patient’s level of payment is not always clear up front.  The claim has to be filed with insurance, adjusted to the contract fee schedule, then the visit might be applied to the deductible and no payment made by the plan.  Rather than waiting for all this to take place, many practices are obtaining authorization from the patient to charge their credit card up to a pre-determined limit when the processing is completed. 

 

Collecting good insurance information is essential.  Rather than asking, “Is your insurance the same?” be sure to look at the insurance card at each visit.  Patients will often complain about this procedure, but when they understand it will help them avoid getting a bill in the mail later, they will better appreciate your practice’s diligence.  Look into using an insurance verification system such as the one offered by InstaMed to then immediately make use of the insurance card information.  These systems allow the office to quickly verify the patient’s coverage, eligibility, and often the level of payment using a national database. 

Know your market

Your practice’s pricing should be competitive within their relevant region, and the fee schedule for common procedures should be readily available for patients to reference.  For more complex procedures, the reception/scheduling staff should have a mechanism for easily obtaining the correct pricing estimates to give to patients when they ask for it.  Being able easily provide this information will assist the patient with their need to schedule a procedure, and it might set your practice apart from others that cannot provide it.  Patients want to know in advance what they will be responsible for; don’t let their confusion, or yours, on this issue drive business elsewhere. 

 

This concern is especially true for imaging centers that are owned by a hospital, as we discussed in a recent article on Hospital Outpatient Departments, where the hospital and physician might be billing separately. Patients are generally unaware of this billing process, so it is often the source of much confusion.  The information given to the patient has to be combined and clearly explained so they can properly check with their insurance plan about coverage.  And, if one entity or the other is not participating with the patient’s insurance plan, the new state regulations restricting “balance billing” or “surprise billing” might preclude collection from the patient. Providing a bit of education on these issues via your website can go a long way toward preventing collection delays later.

 

Accepting as many insurance plans as possible will make it easier for patients to select your facility.  However, if your facility does not accept the patient’s insurance, then a discounted self-pay fee schedule can be offered, along with an opportunity for payment over time when necessary.  If the patient is willing, monthly credit card charges that are pre-authorized will make time-payment plans easier for them and more reliable for the practice. 

Other patient-friendly ideas

There are other ways your imaging center can distinguish itself from the competition and cement patient loyalty.  The radiologists themselves can play an important role by speaking directly with patients to deliver significant results, as we reported in a 2016 blog article.  Like discussing fees, this idea is also counter to the norm that has persisted for generations of radiologists – but the new healthcare economy and its focus on patient-centered, value-based care demands that physicians adopt new ideas. 

 

For hospital-based practices, consider also how your clinical data can be put to work implementing new processes for identifying incidental findings and communicating the need for follow-up care to both patients and their PCPs. We deployed such a system with one of our radiology practice clients and realized clear benefits. Patient follow-up rates increased by nearly 50%.  Among those returning for imaging, 23% had new or worsening conditions where our intervention was clearly needed.  Such an approach helps position your radiologists as proactive stewards of health – a new role that patients and PCPs alike appreciate.

 

Transportation to the imaging center may be provided at no charge to the patient, provided the practice establishes and adheres to a uniform policy consistently applied.  Under federal rules, the offer of transportation cannot be marketed to the public and cannot be used as an inducement to attract patients to the facility.  However, when the patient requires transportation and the practice can provide it, the patient will certainly be pleased! 

Conclusion

In their annual Trends in Healthcare Payments Annual Report, InstaMed concludes, “Prioritizing consumer demands has to become the new normal in healthcare.  If the industry is meant to help consumers, then why is there so much friction in healthcare payments?  Consideration of the consumer experience is often an afterthought.”  Many of the ideas presented in this article have been covered before in our blog, as these are ongoing concerns – in fact, opportunities -- that should be considered heavily by your practice leadership to be sure your patient experience is optimized. 

 

We’ll help keep this topic in front of our readers, so subscribe today to avoid missing the latest information to help you maximize your radiology practice revenue.


Sandy Coffta is the Vice President of Client Services at Healthcare Administrative Partners.

 

Related Articles:

 

Reviewing the Rules for Imaging Centers Operated as Hospital Outpatient Departments

 

Helping Our Computers Help Us: Standardizing Radiology Reporting to Benefit from Emerging Technologies

 

What Does APM Participation Mean for a Radiology Practice?

 

Get free expert advice on radiology RCM

Topics: radiology

Subscribe to our radiology billing and coding blog

Recent Posts

Testimonial

How this radiology practice recovered lost referral volume.