In 2021, the average patient out-of-pocket costs jumped about 10% compared to 2020—or to about $1,650 per person. Experts expect that the rate of increase for out-of-pocket medical expenses will continue to climb by nearly 10% each year for the next five years. That’s on top of the increasing healthcare insurance premiums that Americans are paying, which rose 37% from 2015 to 2020. For healthcare organizations, this comes as no surprise, and it’s adding to the headache of trying to provide high-quality care that prioritizes patient well-being while also turning a profit.
Medical debt is the single most common cause of bankruptcy in the U.S., and when a patient files for bankruptcy, the provider can often expect little to no reimbursement. Fortunately, there is a better solution: early out services. When a healthcare organization partners with an agency that offers early out, they can expect not only prompt payments and workable solutions, but also more satisfied patients who decide to keep returning to that clinic or hospital for future care and needs.
Understanding Early Out Services
By and large, hospitals and clinics want to do what’s right for their patients. They want to provide lifesaving, life-improving care that fits the patient’s unique needs. Yet, it’s difficult to do so while remaining profitable. (According to the American Hospital Association, 22.6% of hospitals were losing money as of 2015.) It can be difficult enough to turn a profit when a substantial volume of patients are on Medicare or Medicaid, but when private insurance patients cannot pay their out-of-pocket bills, the challenge escalates.
That’s where an early out program comes into play. This involves collaborating with the patient, ensuring they are fully informed about their healthcare cost responsibilities, the availability of financial assistance programs, and their payment options. By partnering with the patient in a proactive, empathetic manner, more accounts get paid earlier and in full.
Taking a Look at How Early Out Works
When a hospital or other healthcare organization partners with an ARM agency to develop an early out program, they can expect a comprehensive, proactive approach. Depending on the agency and the specific services the healthcare provider chooses, the early out program may feature the following:
- Patient-Friendly Billing – About 61% of patients are confused by their medical bills and cannot understand exactly what they’re being billed for or what their insurance covers. An early out program should include patient-friendly statements that clear up the confusion.
- Patient Discussions – Agency representatives should take a customer service approach to phone calls with patients, using an empathetic tone and answering questions.
- Insurance Verification – Representatives partner with patients to help them get their medical debts satisfied, such as by checking to ensure that the insurance coverage was accurate. If the insurance company did not pay all contracted amounts, the early out program should include efforts to obtain the proper reimbursement.
- Financial Assistance Qualification – Many patients qualify for financial assistance programs without realizing it. The collections representative can help patients discover if they qualify, and if so, how to initiate the process.
In short, these programs facilitate timely patient payments, preserve the healthcare organization’s reputation, and ensure proper reimbursements.
Working With an Experienced Partner for Your Early Out Needs
Not all agencies have the right blend of experience, knowledge, and empathy to successfully implement early out programs. It’s important to choose the right partner for your program. Look for an agency that:
- Works seamlessly with your existing billing office staff
- Adapts the program to fit your organization’s financial policy
- Is committed to upholding high ethical standards and following the letter of the law
- Takes a collaborative, proactive approach
- Has a long track record of satisfied clients in the healthcare industry
Partnering With CMC: Trusted by Healthcare Companies Since 1966
At Credit Management Company (CMC), we’ve been partnering with healthcare companies for decades, and have developed a sterling reputation for effective, ethical, and empathetic healthcare collections. Our early out program fits in seamlessly with your existing programs and staff. Contact us today or download our healthcare brochure for more information.