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3 ways to set up online payment systems for patients

A practical look at information technology issues and usage

By — Posted May 28, 2012.

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Numerous surveys have found that 75% of Internet-using Americans pay bills online, but the medical industry has been slow to offer these services to patients. A 2011 survey of 1,000 American adults by Intuit Health found more than half would switch doctors if they had the opportunity to perform such tasks as paying bills online. The same number said they still pay most medical bills with a paper check. Only 9% of the gross dollar volume of patient payments in 2010 were made online, according to InstaMed, a health care billing and payment network.

Physician practices don’t have to spend a lot of money to give patients the option of paying their bills online. There are different methods for accepting online payments that are as simple as creating a PayPal account, or as complicated as implementing a fully integrated system that gives patients a billing and service summary. The system that is best for a practice depends on many factors, including the goals the practice wants to achieve, what systems are already in place and how much money it wants to spend. Practices also could implement a combination of these solutions.

Online payment/money transfer services

If the ability to accept payments electronically is all a practice needs, the easiest solution is to set up an account with a third-party credit card or merchant account service such as PayPal. These services are basically a channel for consumers to move money from their account to someone else’s without the vendor implementing security measures to store and transfer financial data on their own. Most are capable of accepting payments from debit or credit card as well as a direct transfer from a checking account.

Some charge a small set-up fee of less than $100, or no fee at all. The accounts can be established online. The cost of operating the account is usually either a per-transaction fee of a few cents or a percentage of the payment, on top of whatever credit- and debit-card processing fees a practice pays.

Practices that don’t have a website, or have a minimal one, still could offer this kind of service by putting a notice on paper bills telling patients where to submit payments, or by providing a link on their website.

Electronic commerce/payment processing software

For practices with an online presence, a website upgrade may be in order. Several third-party electronic commerce software vendors with credit card processing capabilities can be integrated into a website.

Choosing the best software will depend on what additional tools you want to integrate on your website. Some offer tools to build an entire website with an e-commerce component that has search engine optimization tools. Others offer just the tools needed to build a payment processing service on an existing site.

Picking the right solution could rely on the computer skill level of the practice staff. Some software solutions offer step-by-step instructions most people could follow to get it up and running while others may require the help of a website developer.

Just like the third-party websites, the cost of e-commerce software varies. With some, there is a one-time price for the software that ranges from $20 to more than $100. Others are free to set up but then charge a monthly fee, a per-transaction fee based on set fees or percentages, or a combination of both monthly and per-transaction fees. Some systems may be subject to credit card processing fees, similar to those charged for in-person transactions.

Harry Stephens, president and CEO of Datamatx, an electronic and paper billing processor, said any time a third-party is involved in payment processing, it’s important that the transactions are done over a secure SSL Internet connection. A good way to tell whether the page is secure is to look at the URL. Most Web addresses start with “http.” A secure website will add an “s” to become “https.”

An SSL certificate is needed by your Web host and usually costs about $50 a year. The certificate often is included in the price of e-commerce software.

Integrated billing systems

More robust systems can be integrated into patient portals and connect with electronic health record systems. These systems can give patients a more complete look at billing statements and a better understanding of their bills.

Even more robust systems integrate with the practice management system or other business intelligence software. Payment systems that are integrated with existing technology not only provide patients with more information regarding their accounts and bills but also provide better recordkeeping for the practice, said Sunni Patterson, partner at RMK Holdings, a medical coding and billing services company based in Chicago.“Online payment systems can also help practices identify and evaluate their patient process, staffing ratios, charge to payment turnaround time, documentation, workflow channels, payment trends, financial forecasts and other factors pertinent to the growth and maintenance of their practice,” Patterson said.

The downside of setting up such systems is cost. They could run a practice into the thousands, depending on how sophisticated the group wants it to be, and the extra layers of security that are needed because of the amount of information that would be accessible online.

Patterson said another option is contracting with a third-party clearinghouse that offers patients online payment options.

When Charles Crutchfield III, MD, an Eagan, Minn., dermatologist, decided to set up an online payment system, he implemented a PayPal account as well as an e-commerce component to his website. Dr. Crutchfield said he has seen no downside and that patients routinely tell him how convenient it is to pay online.

Once the system was up and running, he added a line to bills that told patients they can go online to make a payment.

Stephens said another method is to print QR (quick response) codes on the paper bills that can be scanned with a smartphone and take the user directly to the website, where they can submit a payment. He said that even though the number of customers submitting payments online has increased during the past few years, “a great majority still prefer to receive a printed bill in the mail.”

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