When it comes to collecting more point-of-service payments, the smallest changes can have the biggest impact on your collection efforts.

Extensive research and testing of consumer psychology shows that tiny adjustments to messaging and processes can drastically influence customer behavior and decisions – or in this case, get more patients to make payment at pre-service or point-of-service.

The best part?

These insights can be deployed within healthcare revenue cycle at little to no cost to your organization.

Here are five ways RCM professionals can start using these simple, rigorously tested tactics to increase point-of-service collection.


1. Tell them why

As humans, when we are asked to do something, we are more likely to comply if we are given a reason. Social psychology tells us this is because our rational minds are always seeking out meanings or explanations to life’s experiences. 

And based on social psychologist Ellen Langer’s now famous Xerox experiment, the “reason” behind our request does not necessarily have to make sense.

In her experiment, Langer asked people waiting to use a copy machine to cut in line ahead of them. She asked to cut in line using three different requests:

  • “Excuse me, I have five pages. May I use the Xerox machine?” (60% said yes)
  • “Excuse me, I have five pages. May I use the Xerox machine because I’m in a rush?” (94% said yes)     
  • “Excuse me, I have five pages. May I use the Xerox machine because I have to make some copies?” (93% said yes)

As this study illustrates, people are more receptive to a request, when it is accompanied with a reason why.

Perhaps even more interesting, the reason given does not have to be a very good one (there was only a 1% decrease in compliance when the reasoning changed from “I’m in a rush” to “I have to make some copies”)

Actionable Takeaway

Train your staff to give patients a reason behind their request for payment. An effective way to transition into your reason is using the word “because.”

Research from behavioral psychologists suggests that using the word “because”puts people into a sort of “auto-pilot” mode – making us more likely to comply with requests.


2. Get a commitment from patients

One of the most powerful influences in our lives is consistency. As bestselling author and psychologist Robert Cialdini explains it, we have a “nearly obsessive desire to be (and to appear) consistent with what we have already done.”

And the way to activate the power of consistency – and use it to influence behavior – is to get people to make acommitment.

Research continues to suggest that when we make a commitment, we have a natural tendency to act and behave in a manner that is consistent with that commitment.

One study takes the influential power of commitment one step further.

A group of researchers tested whether a small commitment would influence more hotel guests to reuse their towels and linens. 

In the study, one group of hotel guests was asked to make a general commitment to be environmentally conscious during their stay. Another group was asked to make a more specific commitment – to reuse their towels and linens during their stay.

The researchers found that although more guests were willing to make a general commitment over a specific one (98% vs. 83%), those that made a specific commitment were more likely to follow-through and reuse their towels and linens (66% vs. 61%).

Also, guests in the specific commitment group were much more likely to adopt other behaviors that were consistent with their initial commitment (i.e. turning off the lights and/or TV when they left their room).

This suggests that using specific commitments not only gets greater throughput from people, but also influences them to adopt other behaviors that are in line with their initial commitments.

Actionable Takeaway

Get patients to commit to making financial arrangements before their day of service. Depending on your pre-service engagement processes, this could mean simply adjusting your staff’s scripting for pre-service calls. Or, if you have more automated technologies on the front-end (i.e. IVR, text, mobile app, email, pre-registration portal, etc.) this could mean adding functionality that allows patients to commit to establishing payment arrangements on the day of service.

To take the influence power of commitment one step further, try making these commitments specific. Instead of asking for a commitment to payment arrangements, have patients identify what payment method they plan on using.

Or, if patients indicate they will not be able to make payment in full at the point-of-service, allow them to commit to meeting with a financial counselor to set-up a payment plan.


3. Leverage social proof

This is a more common principle of persuasion and influence. Put simply, social proof means we conform to the actions and decisions of others because we want to demonstrate the correct behavior in a situation.

This is why customer testimonials are used to influence buying decisions. It’s also why you see night clubs that have a “limited capacity” to create long lines outside their establishments. This visual is meant to entice potential patrons outside of the club, using the power of social proof to lure them in.

Actionable Takeaway

Make payment or setting up payment arrangements at the time-of-service a social norm in your hospital. If you have a stat that shows the majority of your patients choose to be financially responsible and pay for their services ahead of time, coordinate with your marketing department to hang signage that communicates this message.

Or, if the number of patients making payment at the point-of-service will not have enough persuasive power, try adjusting your registrar scripting.

When registrars discuss financial arrangements, they can position certain account resolution options with messaging like, “The majority of our patients with balances in this range choose to use a payment plan because it lets them… (insert patient benefit).”

Or, if you know how much financial assistance and/or charity care your organization provides per year, create signage and/or add this to your messaging for patients that likely qualify. Communicating that several families have been assisted financially by your organization may be the small change needed to break through the action paralysis of your charity eligible patients.


4. Use the patient’s first name

When attempting to influence others, research shows that using people’s first names increases their motivation to do something.

For example, an experiment conducted for a group of British physicians found that using a patient’s first name in an SMS text message appointment reminder reduced no-shows by 57% (as opposed to reminders that did not include a first name).

Even more interesting, using a formal salutation (i.e. Mrs. Smith) versus a full name (i.e. Jane Smith) had no significant impact. Only when the first name was used were these effects realized.

The British government found success with a similar tactic. In text messages requesting citizens to pay a fine, they found that including the offender’s first name increased response rates by almost half – from 23 percent to 33 percent.

Actionable Takeaway

Find a way to use your patient’s first name in your pre-service engagement strategy. Whether it’s during your staff’s pre-service calls, in your electronic appointment reminders, or during your point-of-service interactions, it’s a small change that requires zero budget spend. Using the patient’s first name can help “warm” the patient, making he or she more responsive to your requests for payment or establishing payment arrangements.


5. Use future pace

This small tactic works by getting the people to think positively about the future. More specifically, it gets them thinking about the future benefit of completing your requested action.

Normally, this tactic is deployed by the trigger word “when.”

For example, a real estate agent tells a potential homebuyer, “When your friends come here to visit this summer, this back patio will be perfect for a barbeque.”

Or, a car salesman tells a prospective buyer, “When you leave the lot today in this car you can put the top down with the push of a button –and really start enjoying this great weather we’re having!”

It’s subtle, but by using the word when, we are assuming that the person we are aiming to influence has already completed our task or request – allowing them to “experience” the positive effects of making this decision.

Actionable Takeaway

Help patients see the future benefits of making payment arrangements prior-to or at the point-of-service. Whether you position it as helping them save time when they arrive for services or giving them one less thing to worry about when they leave your facility, these small changes to scripting and messaging can make the difference between a “yes” and a “no” from the patient.

The problem with how point-of-service collection is typically approached

Scoring, segmentation, estimation, a best-in-breed payment solution – these are all great things to have in place. However, what tends to be overlooked is how strategically engaging patients can drastically impact point-of-service collections. Because at the end of the day, providers still need to effectively influence patients to make payment at the point-of-service.

As part of RevSpring’s Active Patient Engagement™ we try to provide insights that help RCM professionals expand their mindset around these processes – highlighting technologies and tactics that drive the optimal financial outcome for providers.

The real success with POS collections comes when you realize that it is a fluid process and requires a more holistic approach. The right solutions and technology should be aligned with the optimal patient engagement strategy.

And as the research in this article demonstrates, improving point-of-service collections does not necessarily require a hefty investment. The key is to consistently test new tactics and track your results – continually striving to improve your financial performance.


Sources used for this article:

Emerge CF

5 steps to collecting more payments online

Compliance Audit Services

IWS Video