Transition from Patient Billing To Guarantor Billing

Nick McLaughlin,
Ridiculously Nice Sales and Business Development

Most healthcare billing systems are great at combining bills from different encounters on a patient or account basis. However, a higher level of customer service can be achieved with guarantor, or household billing.

Allow me to set the scene. Greg and Stacy have three children and the whole family is under Greg’s employer’s health plan. Greg will be the guarantor no matter which child is the patient. In most billing systems, if Stacy brings a child in for an office visit, Greg has a knee replacement, and another child has to visit the Emergency Department, Greg would receive a separate bill for each patient, with none of them reflecting Greg’s total balance with ABC Healthcare. In our experience at Americollect, guarantors like Greg would much prefer to have one, guarantor-level statement with ABC Healthcare. Meaning each statement would include self-pay balances for all members he is the guarantor for in the household. Not only does aggregating the accounts under one guarantor improve the patient experience with billing statements, it improves the patient experience working with your Patient Financial Services Department. Greg no longer needs to bring up each account number with your Customer Service Representative, one-by-one, and add them up to get a total balance.

How To – Guarantor Number Creation

For starters, defining terminology is the first step to take when discussing guarantor billing. Below are common healthcare system terms:

  • Medical Record Number – unique set of digits associated with the patient
  • Guarantor Number – unique set of digits associated with the guarantor
  • Account Number – unique set of digits associated with the date of service

The system you use today may already be using this type of combination. If not, we may be able to help you improve the patient experience through guarantor billing.

The guarantor number in this case is critical to successfully executing this flow. However, at Americollect we understand some healthcare information systems are more challenging to use, and may need more attention to develop. Americollect has designed programming to take common data elements such as name, DOB, and address to assign guarantors and created custom programming to manage, organize, and create a guarantor-based statement. The guarantor then receives a statement once per month on all balances currently in self-pay. If an account is paid in full, we manage their statement cycle, and as the guarantor balance increases with successive services, we work with our clients to customize the best statement workflow for them. Greg and his children will be on one statement. Greg’s wife, since she is her own guarantor, would be on her own. Some organizations manage their guarantors by whomever brings the child in, and not whomever holds the insurance policy. We have seen that process work just as well. Greg receives his proper statements for all his self-pay responsibility and Stacy receives hers.

Result – Improved Patient Experience

The best part is that we have integrated our phone systems and calling workflows to ensure Greg or Stacy have received at least one statement reflecting their current total balance before calling their accounts. We always want to discuss their total guarantor account balance, and create a full-scope conversation to shape the patient experience from the back-end to the front-end. This saves your customers and your team time on the phone discussing multiple accounts at different times, and time is money!



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