The final billing notice presents a unique set of challenges for healthcare organizations. 

For some RCM professionals, “patient collections” is still treated as taboo within their organization. And as a result, this mentality is often reflected in the final notice communication they send to patients.

To avoid upsetting, or intimidating patients, these organizations avoid using verbiage or design elements that communicate the urgency of the outstanding account.

While this approach is well intentioned, it is vulnerable to an unfortunate scenario: patients being placed in bad debt because they did not fully understand the timeline or consequences of their outstanding accounts.

So, what is the right approach?


The most effective strategy for “final notice” communications

For starters, it’s important to identify which patient segment should be placed in bad debt.

Patients in bad debt should be individuals that have the means to pay their outstanding accounts, but choose not to do so.

In all other scenarios, it is up to the business office to effectively communicate with the patient and drive some form of account resolution – whether that’s collecting payment in full, setting up a payment plan, or providing financial assistance.

At RevSpring, we advocate a dynamic patient communication strategy.

This means that statement layout, color, messaging and other design elements should change based on varying intelligence – including the age of the patient account.

Typically, the pushback we receive from prospective clients is that a final notice, designed to increase urgency, is too aggressive and not “patient friendly.” 

However, since the release of our Design Analytics service, we have found that patients do not particularly value the “friendliness” of a billing communication.


What patients really want

Our process of testing statement design concepts for usability and comprehension has shown us that patients across the board value clarity and transparency above all else. When billing information, next steps, and account resolution options are presented clearly, from both a messaging and design perspective, patients associate this with good customer service.

In our most recent Design Analytics session, we received feedback from a tester that sums this idea up perfectly. While complimenting the color scheme and overall design layout of the communication, the tester said:

“Honestly if I received a bill like this…I would consider that to be customer service that is above and beyond what most companies provide.”

There is no magic formula for how aggressive or urgent a final notice communication should be.

However, we have found that the key to success is presenting a clear and transparent notice – a communication that outlines how a patient can take action, but also the consequences of inaction.

Not only do patients expect and value these efforts during their billing experience, but it better positions providers to reach some form of account resolution before placing an account with Bad Debt.

And at the end of the day, isn’t this the patient experience and business outcome we want to drive for our organizations?


Important note for tax-exempt hospitals

With the recent finalization of 501(r) regulations, not-for-profit hospitals must create and provide patients with ECA Initiation Notices. The requirements for the written ECA Initiation Notice is outlined in Section 501(r)(6).  

At RevSpring, we anticipate that this Extraordinary Collection Activity Notice will take the place of “final notice” communications for these hospitals. Hospitals adjusting for these rules in 2015 should ensure that the information provided is not only clear and transparent, but that it mirrors the policies in place at the organization.


About the Author

Casey is the Vice President of Direct Healthcare Sales at RevSpring. He has spent his 14+ years in the RCM space developing customized patient engagement and payment strategies for healthcare clients.

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