Patient Payments: Expectation vs. Reality

As a physician, billing specialist or operational associate working within a medical practice, it can be easy to make assumptions. Those within the industry have an innate understanding of what makes a practice tick, but sometimes those on the outside (yep, we’re talking about your patients) perform differently than expected when it comes to the in-office experience, payment preferences and their healthcare demands. Let’s dive into a few common assumptions and misconceptions and separate fact versus fiction.

EXPECTATION: Patients have a solid understanding of their medical coverage

REALITY: While terms like deductible, co-pay and co-insurance and may be commonplace in a medical office, the truth is that many patients are unfamiliar with the meanings. Throw in acronyms like EOB and AR and it becomes even more complex for patients! The truth is that insurance-related terminology is foreign to many people. In fact, a survey of 2,000 Americans with health insurance from Policygenius determined that a whopping 96% did not understand basic health insurance terms. And the age group that holds the title for lowest comprehension? The honor goes to Millennials. So how can your practice improve healthcare literacy? Educate your patients on their coverage and what it means, whether that’s through online resources, in-office signage, or a one-on-one conversation at the time of service.

EXPECTATION: Patients expect long appointments and a time-consuming office experience

REALITY: We’ve all been there. You arrive early to a 9 a.m. appointment, only to sit in the waiting room for an hour. Then the doctor is behind schedule, and so on and so on. Before you know it, what should have been a quick checkup turns into a three-hour affair. These occurrences may be all-to-common, but today’s patients are pressed for time and have high expectations. Thankfully, tech-driven features like Express Check-in can replace paperwork and improve the patient experience.

EXPECTATION: Patients comprehend their financial responsibility  

REALITY: Unfortunately, patients are often left in the dark when it comes to what they owe. But we know that patients who know their costs upfront are more likely to pay, so providing accurate upfront estimates is a best practice. Cost estimation tools generate clear cost estimates so the patient knows exactly what is owed at, or before, the time of service. Once financial responsibility is clarified, it’s easier to facilitate deposits and gain a credit card on file before a patient leaves the office. As an added bonus, this transparency builds trust and loyalty with your patients (while improving collections at the same time!).

EXPECTATION: Patients adequately budget for medical expenses

REALITY: While a medical biller hopes that paying for an office visit or procedure is a top priority for a patients, the reality is that about 40% of Americans would have trouble paying a $400 medical bill. This has led to 23% of Americans having medical debt, according to a 2022 Lending Tree survey. The ability varies by patient, of course, but in today’s economy, sometimes a medical bill takes a backseat to more immediate needs.

EXPECTATION: Older patients prefer traditional payment methods

REALITY: Tell the truth – does your front desk staff paint payment preferences with broad strokes and assume that any Gen Z or Millennial that walks into the office prefers to pay digitally? On the flip side, it would not be farfetched to believe that Baby Boomers still hope to receive a paper bill in the mail, right?

You may be surprised to learn that payment methods do not vary too wildly between the generations. In fact, a PAYMNTS survey found that 8% of seniors completed a payment through a physician’s website – the same percentage tied to Gen Z patients. When it comes to older Americans’ preferred ways to pay, in-office (38%) and through a payment portal (21%) edged out the more traditional snail mail method (19%).

What expectations have differed from reality in your experience?



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