Self-Pay Case Study

Case Study | May 3, 2022

Hospital Overcomes Billing Obstacles, Reduces Costs, and Increases Collections 

The Challenge

In 2016, a hospital system in New York converted to a new electronic health records (EHR) platform. Unfortunately, the conversion went poorly and one of the most notable casualties was the hospital’s self-pay process. Billing statements were significantly delayed. Some patients didn’t receive a bill until a year after service. Additionally, their statement design options were limited, and patients found them complex and hard to understand. This factor, combined with a lack of coordination with the early-out vendor that managed and pursued self-pay accounts, resulted in some patients getting calls about statements they hadn’t yet received. The situation was even making waves on social media and the local news. “It was just a flat-out nightmare,” said the Sr. Director of Revenue Cycle. “We knew we needed to do something.”

The Solution

To overcome its self-pay challenges, the hospital turned to Elevate Patient Financial Solutions, its current Medicaid eligibility partner.

“When we chose ElevatePFS, the solution was exactly what we needed,” said the Sr. Director of Revenue Cycle. “The pricing allowed us to get some savings we hadn’t anticipated, but we had to work on a better statement.”

ElevatePFS worked closely with the client and EHR system provider to optimize the client’s patient statement – ensuring it was clear, concise, and easy for patients to understand what they owed. In addition, the new design helped patients identify what their primary or secondary insurance covered and set up installment plans—ultimately driving expedited patient payments and increasing overall collections.

Previously, the client received an overwhelming number of patient calls with complaints or questions about their bill. With ElevatePFS, fewer patients call with questions while more are paying in full or enrolling in payment plans. Now, patients understand their statements, and the hospital can focus on other essential areas.

“ElevatePFS has gone above and beyond. There’s nothing we’ve asked for that they haven’t done their very best to accommodate.”  Sr. Director of Revenue Cycle 

The Results

Thanks to a more straightforward statement and helpful approach to engaging the self-pay patient through ElevatePFS’ proactive U.S.-based call center, the hospital can collect more and devote precious resources to other areas of the revenue cycle. Since implementing ElevatePFS’ Patient Responsibility services, the hospital’s collection rate increased from 34% to 57% in five months.

ElevatePFS Outperforms Previous Vendor's Collection Rate

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The Elevated Difference

By focusing on the patients’ needs and providing a more positive billing experience, ElevatePFS resolves claims more rapidly and efficiently, resulting in increased collections and happier patients. In addition, developing new, easy-to-understand statements added more value for the hospital and made a difference in their revenue. By becoming a trusted partner, ElevatePFS delivered a win-win situation for both the hospital and its patients.