Cash flow is as important to your facility's fiscal health as it is for your patients' household budgets. Today's high-deductible healthcare plans can threaten both, as many patients stress to obtain the thousands of dollars they must pay out of pocket on the day of surgery. That's where patient financing plans can help. Patients who struggle to cover the cost of their care when they arrive at your facility can sign up for a medical credit card, which they can use to charge their deductibles. About 20% of our patients take advantage of the service to receive the care they need. The financing plans also allow our facility to get paid in advance of procedures, a key factor in ensuring we run in the black. Here's how we've designed our process to ensure we're providing access to care in a way that allows us to run a profitable business and support our patients.

Patient financing companies charge various processing fees on the amount patients borrow. We allow our patients to choose from three plans offered by our vendor. The most popular is a six-month plan that allows them to pay back what they borrowed at no interest. The other two allow the patients to repay over a 24- or 36-month period at moderate interest rates. We're charged about 3% of what the patient owes us by the financing company. In other words, we receive the amount of money the patient borrowed from the company — minus the 3% processing fee — within 24 hours of the patient signing up for the plan.

Our patient financing company also offers a 24-month, no-interest plan that we could offer our patients, but the company would take a whopping 13% of what the patient borrowed as a processing fee. We can't run a business that way and decided not to make that plan available to patients. There are other plans that would allow the vendor to take 9% off the top, which is still high. You must be very careful about which plans you accept from your vendor and offer to your patients. Knowing the details of the available plans is important, as some of the best plans for your patients come at your facility's expense.

When patients sign up for a no-interest plan, make sure they understand they have to pay each monthly bill on time, and that the amount of money they borrowed has to be completely paid off within the timeframe designated by the financial company in order to avoid interest payments. In our case, we inform patients who opt for the interest-free financing plan that their balance must be paid in full within six months. It's essentially an interest-free loan for six months if they pay on time and in full. If they miss a payment, high interest rates will kick in.

A quick warning: Make sure you're constantly monitoring your online account with the patient financing company. The payment plans they make available to patients, but that you don't offer, should be blocked to prevent the possibility of a patient taking advantage of low interest plans that include exorbitant processing fees for your facility.

Working with a patient financing company helps us maintain our cash flow

Read the details for each plan that's offered, and search for hidden fees. If you need a quick turnaround on the money you're owed, find out how long it takes to get to your bank account after the patient signs up. You don't want a financing company to charge a reprocessing fee, then force you to wait to get the rest of the money that you're owed. If the vendor has a parent company, make sure it's a reputable financial institution.

Also consider the user-friendliness of the service. It was important for us to give our patients the ability to apply online for a credit card in our facility on the day of the procedure. Does a company's application process have hundreds of steps and is it so cumbersome that it slows your check-in process? If so, look for other companies that have more streamlined access. Make sure the system's online portal is easy for your staff to negotiate. Ask if the company has security oversight. Our vendor calls us periodically when they see a transaction to make sure it's legit.

We employ an insurance verification specialist who is a key part of our staff. The specialist knows all the details of the patient's insurance situation in advance, including what percentage of their deductible they've met and the amount of their co-insurance or co-pay. We also participate with a billing company that assists in the verification process by accessing all insurance plans. The system then communicates to the patient via text about how much they'll owe the facility, with a link to a website that explains their benefits and offers them payment options.

Having this information is key to our decision making when patients are in front of us on the day of surgery. Our policy is to be paid at the time of surgery whenever possible. Make sure your staff are comfortable having these conversations with patients. They need to understand the importance of collecting the money up front. Again, we can't be the patients' bank, and it's not being mean or harmful to patients to say so. It's simply being truly fiscally responsible. Most patients pay their bill with a credit card. If they can't, we're able to offer of the services of the patient financing company.

Having a patient financing vendor on board is very helpful to your business office on the back end of your financial transactions. It minimizes your accounts receivable collection efforts and ensures a steady revenue flow for the facility. Date-of-service collections make a hugely positive impact on the bottom line of every center. If it turns out that a patient's deductible was met elsewhere, prior to their procedure here, the center can quickly refund the patient using their healthcare credit card, so they don't have to wait for us to sent them a check.

As the administrator, I'm involved in all the cases of people who can't or won't pay up front. Unfortunately, a small percentage of patients balk at paying, don't want to apply for a healthcare credit card and have no intention of paying after the procedure. Sometimes the mere mention by my staff of my involvement causes people to start producing money they said they didn't have right out of the sky. Other times, I'll have to have a tough conversation, saying the procedure they're about to have is elective, and they'll have to save money and come back in several weeks.

Of course, there are always situations where a child needs their tonsils out and the parents are struggling or not good financial managers. I approve those procedures and thankfully have always had physician support to do so. In these cases, we can sometimes work out a deal in which the parents will agree to pay us half of their deductible up front and the rest over time. Working with a patient financing company helps us maintain our cash flow, so we're able to make these accommodations for patients in need. The service plays a significant role in keeping our facility fiscally solvent, allowing us to focus on providing the highest in quality care. OSM