At the Margins

Do you provide non-emergency patients a pre-service bill? Maybe you should.

by Robin Brand and Trevor Goldsmith

The unified (or consolidated) bill has captured the time and attention of many health system finance leaders trying to make their revenue cycle more responsive to consumers' expectations. Aggregating all the different fees from an inpatient stay together in one easy-to-understand format is a logical response to a consumer need. A consolidated bill eliminates the patient confusion that stems from the status quo: a series of bills full of medical jargon from various sources that may include the hospital, multiple physicians, and even lab and radiology.

But it's not at the top of consumers' wish list. In fact, when we surveyed 1,000 individuals who had undergone elective surgery recently, the unified bill came in at fourth place.

Survey ranking of service offerings that would most improve the financial experience

  1. Pre-service bill
  2. Online price estimator
  3. Financial counselor
  4. Consolidated bill
  5. Patient portal
  6. Payment plan
  7. Financial call center

[Survey question: Please rank the following offerings according to how beneficial they would be to you if you were undergoing non-emergency surgery.]

In fact, receiving an accurate estimate prior to service is what is most important to patients. A pre-service bill ranks as the number one financial service offering. Not knowing what they will owe only adds to the anxiety that patients already feel before any major health care service.  And with continued press coverage of the wild variation in health care pricing, a patient wondering  “Will it be $500 or $5,000?” is unfortunately not an exaggeration.

In addition to removing unnecessary financial uncertainty, the pre-service bill aids health system revenue capture in two ways. First, delivering the pre-service bill provides hospitals the opportunity to introduce patients to payment plans or the possibility of discounts according to charity care policies. And when patients have an accurate picture of their obligations well in advance, they are better prepared to meet them.

Billing preferences matter, but you don't need to choose

Fortunately, a pre-service bill and a consolidated (post-service) bill are not mutually exclusive revenue cycle objectives. In fact, they serve as bookends framing the patient encounter since a pre-service bill—to be maximally useful to the consumer—should contain the same breadth of information as the bill patients later receive after discharge.

Download this resource to learn more about how you can improve the patient financial experience while improving your own financial performance. Our resource includes additional insights from our consumer survey and best-practice case studies from progressive health systems.

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