Easy Ways to Navigate Awkward Financial Conversations With Your Patients

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Patient Collections Overhaul

Last month we discussed the growing rate of financial stress among most patients in our blog post, “What to Expect From Your Patients in 2021: Financial Stress.” Feel free to give it a quick read if you missed it. This week I’d like to expound on that article and hone in on how to navigate financial conversations with your patients in a way that empowers them to pay their medical bills.

It’s not new news that the COVID-19 pandemic has wreaked financial devastation on many. Patients are financially stretched, yet healthcare facilities also took a huge financial hit. There’s no doubt about it, the tension on both ends of the rope is tight and if adaptive changes aren’t made, the rope will break. According to this survey by Parallon, “88% of healthcare providers indicate that COVID-19 has impacted their approach to patient collections in some way. And nearly 20% (18%) go so far as to say that the virus has impacted their organization’s approach in every way. That means that almost one in five healthcare providers are overhauling their entire patient collections strategy because of the virus.” (1) Let’s take a look at some of the implemented changes leading to patient satisfaction, and much-needed revenue for healthcare facilities.

Communication is Key

It all starts with effective communication. Most of the time, patients are confused or caught off guard with medical bills. Frequent, compassionate, and informative communication regarding their financial responsibility can eliminate confusion and surprise billing. Jordan Rosenfeld quotes David Shelton, CEO of PatientMatters in his article for Medical Economics: “Our experience is that most people truly want to pay their bill. The challenge has always been whether the healthcare provider will have the conversation with them at the very beginning, taking into account their financial challenges or opportunities.” (2) Rosenfeld highlights that financial conversations need to be embedded in every layer of the patient’s experience, start to finish. Therefore, it’s of utmost importance that healthcare companies properly educate and equip their front office staff to handle financial conversations in an effective manner. This means training them in areas beyond their immediate job tasks, such as communication and insurance.

Non-Verbal Communication

In her interview with Insights from the Outside (a CareCredit team), chief quality officer of Medical Eye Center, Patty Casebolt, explains the importance of being able to interpret patients’ body language and non-verbal cues. She states, “If you are paying attention to more than just the words that are spoken, you will be more effective in your communication. This is especially important in the time and environment that we are in currently. Some people are more stressed for a variety of reasons. It is helpful to have a heightened awareness of this and be mindful of slowing down and tuning in to your patient/customer, as well as yourself. Stress breeds stress, so paying attention to your own emotional regulation is vital as well.” (3)

Cost-of-Care Conversations

In her blog, “Strategies for Effective Cost-of-Care Conversations with Patients,” Jacqueline LaPointe gleans from the vice president of revenue cycle at Montessori St. Luke’s Cornwall Hospital, Jill Barton. Barton explains how she trained members of the hospital to have “cost-of-care conversations” with patients. She encourages, “You need to invest in the front-end by improving the quality of training and your staff’s ability to communicate and help people understand their health insurance… We increased the level of education for our front-end staff so they can not only answer medical-related questions but also read the patient and understand their anxiety about the financial process as well… Technology is definitely a very key component. But people are just as important.” (4)


In her Cost-of-Care Conversations article, LaPointe writes, “Providers and their staff can start having effective cost-of-care conversations by integrating the discussions into the provider workflow, calculating out-of-pocket cost estimates, creating scripts, and screening patients for cost distress.” (4) She notes that because Barton incorporated the strategy of developing and rehearsing a script with her staff, the small New York hospital recorded a significant increase in patient payments.

Enhanced also touches on the effectiveness of rehearsing scripts in their article, “7 Financial Scripting Tips to Help Collect Patient Payments.” They provide an example of a financial conversation:
“According to your insurance benefits, your financial responsibility includes a $10 copay, 10% coinsurance and a $1,000 deductible. Your insurance company indicates that you have met $500 of your annual deductible. Based upon services that will be provided during your appointment, and after combining the $500 remaining deductible, copay and coinsurance amounts, the total amount you will likely owe at the time of service is $310. I will be happy to walk you through the price estimation if you’d like.” (5) Helpful, confident, educational, and clear.

They also include “7 Tips to Remember as You Develop Patient Pre-Collection Scripts:”

Be Human

Be empathetic and relatable. I’d like to add to this – introduce yourself. Starting the conversation off by telling the patient your name communicates a friendly demeanor, relatability, and a willingness to help.

Avoid Open-Ended Questions

For example: “I see you have a $50 amount due. Are you able to pay today?” Instead try, “I see you have a $50 amount due. Would you like to use Visa or MasterCard to pay your balance today?”

Provide Realistic Payment Options

If a patient is having difficulty paying the full amount owed, offer solutions according to your financial policies. This will go a long way with the patient and will most likely result in the patient paying their full balance.

Invite Questions

Your job is to help educate the patient. If they have questions, be willing to help answer them with kindness, rather than viewing them as a nuisance.

Maintain Eye Contact

Financial conversations do not necessarily have to be awkward or apologetic in nature. The healthcare facility should have confidence in the care they’re providing and the well-earned compensation for those services.

Prepare for Objections

Objections are inevitable. Creating a list of potential protests can be helpful in preparing for them.


Practice these scenarios as a staff. Role-play financial conversations.

Empower Patients

Combating the taboo nature around financial discussions head on can create a culture within a healthcare facility that puts patients at ease and helps you collect necessary funds. Communication all throughout the patient experience is key, and it’s of utmost importance that the entire staff is trained in having financial conversations. I’ll leave you with LaPointe’s concluding words in another blog she wrote for Revcycle titled, “Key Ways to Boost Collection of Patient Financial Responsibility,” “With the shift in patient financial responsibility, healthcare revenue cycles are more dependent on the patient than ever before. Providers may need to retrain their staff to effectively communicate with patients and collect payments. At the same time, healthcare employees should also help to empower patients to take charge of their healthcare costs, which will help providers see more patient revenue.” (6)

Please let us know if you have comments or questions, and subscribe to our Email Updates, so that you can be assured to receive Thinking Thursdays TIPs.

Thank you!

Jerry L. Stone
MedicalGPS, LLC


  1. https://www.hfma.org/topics/hfm/2020/november/survey-covid-19-profoundly-affecting-patient-collections-and-financial-assistance-programs.html
  2. https://www.medicaleconomics.com/view/benefit-flexible-patient-payment-options
  3. https://www.homecaremag.com/form-embed/managing-financial-conversation-emotional-intelligence
  4. https://revcycleintelligence.com/news/strategies-for-effective-cost-of-care-conversations-with-patients
  5. https://www.enhancedrevenuesolutions.com/2019/06/20/7-financial-scripting-tips-to-help-collect-patient-payments/
  6. https://revcycleintelligence.com/features/key-ways-to-boost-collection-of-patient-financial-responsibility

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