Study: Doctors aren't ready to help patients determine expenses

Almost half of the healthcare providers in a recent survey say they can’t calculate a patient’s financial responsibility until claims are submitted and processed - a serious hindrance to point-of-care services that patients are seeking these days.

The survey, conducted by NaviNet, was released Monday at the Healthcare Financial Managers Association’s ANI: The Healthcare Conference 2009 in Seattle. Conducted May 6-26, it garnered responses from 1,279 U.S. healthcare providers.

The survey focused on patient payments and credit care use, and indicated that one out of every five doctors do not accept credit or debit cards. They blamed high processing fees and hardware costs, as well as concerns over financial industry regulations, as reasons for not accepting the cards. And of those who do accept credit and debit cards, the survey indicated, 87 percent said they only allow them to be used for co-payments.

“For healthcare providers, managing revenue must be as much a core competency as the delivery of services, and needs to become more proactive and disciplined,” said Vi Shaffer, research vice president at Gartner, in a press release issued by NaviNet. “With patient self-payments on the rise, verifying eligibility/necessity, accurately estimating obligations, and then cost-effectively collecting the patient’s portion of the bill at the time of service is becoming quite crucial.”

According to the survey, 31 percent of providers said they lose revenue due to uncollected patient payments – making it crucial to determine financial responsibility at the point of care. According to a report from the National Association of Healthcare Access Management, a provider’s ability to collect the full amount of patient payment drops to less than 20 percent after the patient has left the physician’s office, clinic or hospital. Another report, in The McKinsey Quarterly, estimates that patient out-of-pocket expenses will grow to $420 billion by 2015.

“Our practice has often struggled with determining patients’ financial responsibility, especially as their health insurance coverage changes frequently,” said Linda Chufe, manager at Bell, Froman, Orsini and Associates, a Beaver, Pa.-based clinic. “Real-time access to eligibility and benefits information helps us communicate financial responsibility to patients at the time of care and enables us to have informed discussions with patients about payment options, which ensures collection.”