Business Solutions Drive Meaningful Results for Pharmacies

As a trained pharmacist and health care consumer, I am proud to see how the pharmacy profession has evolved and now, more than ever, is providing more vitally important health care services. In a time when provider labor shortages are abundant, pharmacists are stepping in front and center to help care for patients and provide much needed access to medical care in our communities.

Today, pharmacists are managing and administering vaccines, performing patient care visits, providing medical equipment and supplies, monitoring patient drug therapy, and in some states, prescribing medications. With growing patient responsibilities for pharmacists, the business side of pharmacy is evolving too. As more patients see pharmacists for care, pharmacies are being confronted with new patient engagement and billing challenges.

Services in the pharmacy and retail clinics are being billed in different ways, oftentimes under the medical benefit structure, which will only continue to grow. In addition, health care payment models are rapidly changing at a pace never seen before.

Listening to the Voice of Patients

How can pharmacies manage these challenges while maintaining high levels of patient satisfaction? It begins with listening to patients.

RevSpring’s 2023 Voice of the Patient Survey of 1000 US patients revealed that a one-size-fits-all engagement approach will leave some patients unsatisfied. Patients want their unique preferences followed—87% reported it’s at least somewhat important that their providers follow their preferred communication channels, with more than half saying it’s very important.¹

Not honoring patient preferences can erode trust, as 4 out of 5 respondents agreed they would be more likely to trust their providers if they communicate with them using their preferred choices.²

Personalization based on preferences is the gold standard of health care engagement and it’s no different with pharmacy patients. The stakes are high because patients will switch providers due to a bad experience.

The majority of respondents in our survey reported they would be at least somewhat likely to switch because of poor communication during the pre-care experience (67%) and 56% said a poor billing experience would lead them to consider changing providers.³

Leveraging Proven Patient Engagement and Billing Solutions

Proven technologies successfully used by other providers offer sound solutions to the business challenges facing pharmacies—from before a patient comes onsite until long after they pick up a prescription or receive a service. Smart health care-focused technology solutions not only inspire patient actions, they empower your staff.

This begins with understanding how to contact patients in ways that will garner the best response, particularly when payments are due. Patient data analysis can quickly and efficiently create profiles, including how best to engage. For pharmacies with vast contact information databases, such as patient phone numbers, reaching out most effectively could include:

Texting

For patients who respond well to prescription reminders via text, it’s possible to leverage that same technology with a different message, such as appointment reminders or text-to-pay correspondence to resolve outstanding balances after the insurance portion has been rectified. Text-to-pay also can inspire patients to pay before they pick up a prescription, giving them the same convenience offered by “grab and go” digital coffeehouse orders.

Research shows that 95% of texts are read within 3 minutes of being sent and, on average, are responded to within 90 seconds.⁴ This is an excellent technique for speeding up receivables of outstanding balances and reducing accounts heading into bad debt.

Interactive Voice Response (IVR)

Most pharmacies have a base of patients who may not respond via text, but will use their phones to communicate in other ways. This allows pharmacies to leverage technology already in use with their prescription practice to facilitate medical payments. Both outbound and inbound IVR is a cost-effective way to communicate with pharmacy patients.

It’s also possible to use inbound IVR to offload many calls normally bombarding pharmacy staff regarding outstanding balances, making or arranging payments, and receipts. Many health care providers experience up to 75% of inbound IVR calls resulting in a payment.⁵

Outbound IVR is quite effective too, with health care providers realizing a 40% reduction in a typical 120-day accounts receivable cycle.⁶ Pharmacies can automate communications about overdue balances, denied claims, or pre-registration for an upcoming appointment. All uses of IVR accelerate the new revenue cycle for medical services provided at pharmacies.

In addition to texting and IVR, email and print are also popular with many patients. With so many communication vehicles, how do you know which to use when and with whom? Using an omnichannel approach works for many health care organizations. This relies on data analysis to understand how patients prefer to receive and respond to messages.

People are complicated and may prefer one method, such as email, for some messages and something entirely different, say text or even print, for other communications. Taking a digital-first approach can reveal which patients are most comfortable with text or email—at least for some of the communications you send—saving you the expense of print and mail in many cases.

Optical Character Recognition (OCR) Increases Data Accuracy and Patient Ease

OCR technology allows patients to quickly and accurately complete digital forms, reducing the administrative burden on staff during the preservice registration process. It also greatly increases convenience for patients, while eliminating common errors that create time-consuming and expensive problems like insurance claim denials.

Using the camera on a personal device (cell phone, tablet or computer), patients upload images, such as drivers’ licenses and medical insurance cards. OCR then scans the images and converts the content to text. This process can be configured according to providers’ needs so the gathered information precisely fulfills specific data requirements.

Messages Matter Too

Empathy is critical in inspiring patients to engage and act. Empathy—informed by data, analytics, and feedback—must drive the patient experience to ensure the experience will align with their specific needs. In fact, more than 70% of survey respondents agreed that they would pay sooner when presented with the option that best suits their ability to pay.⁷

Billing statements are the obvious result after a patient’s insurance has been applied. No matter whether it’s a paper statement or an electronic one, there are proven methods for enhancing a provider statement to promote action including patient-centric messaging.

Leveraging your customer knowledge can extend to providing different payment methods, such as a QR code or link to an online payment portal. Including these options in a printed patient statement can encourage even the most technology-averse patients to dip a toe into the digital waters.

Tailored statement designs and calls to action promote faster payments. This personalized approach communicates an important “meta message” to your patients:it’s easy to engage with your pharmacy for medical services.

Messages used in patient statements, texts, and IVR technology can be tailored to fit each patient’s financial profile. For example, billing balances may be higher due to the medical services provided, as compared to the amounts pharmacies typically see with prescription balances. Therefore, pharmacies may need to infuse more empathetic messaging to those with higher balances and offer payment plans or even patient financing.

And pharmacies can alter messaging based on how far in the billing cycle a patient falls. Increasing the sense of urgency as a patient gets closer to being classified as bad debt may catch patients before this occurs.

Payment Portals

Offering your patients a well-designed payment portal is another proven solution for convenient payment engagement. Portals can be used in conjunction with text messages and as mentioned above, QR codes to make finding and using the portal convenient for patients who prefer to pay in this way. This is especially important to mail order and specialty pharmacies who need to capture payment up front and/or store credit cards for convenience billing through the refill cycle.

Some pharmacies are creating other innovative ways to leverage payment portals. The Mark Cuban Cost Plus Drug Company, for example, is engaging with my company as a payment partner for its new program with US pharmacies. RevSpring, in an innovative application of our PersonaPay payment portal, will orchestrate pharmacy billing and give participating pharmacies an efficient way to track prescription sales through our 12-month payments tracking dashboard.

The Bottom Line

Each patient is unique: their financial obligations and payment abilities are wide ranging and their responses to messaging vary. By understanding and respecting these differences, pharmacies increase the likelihood that patients will meet their current financial responsibilities and continue to visit them for future medical needs. This is crucial as pharmacists and pharmacies increasingly assume more provider responsibilities in the resource-challenged US.

Using proven health care technology and engagement strategies ensures that receivables from added medical services will not bog down a pharmacy’s revenue cycle management process. Instead, pharmacies can promote patient satisfaction with medical services, precise communication messages, and appropriate financial engagement tools that will strengthen their relationships with patients while effectively collecting for the expanded medical services they provide.

Valerie Mondelli, executive vice president and chief commercial officer, RevSpring.

* 2023 Voice of the Patient Survey Methodology
The study, conducted by research firm Keypoint Intelligence, included a quantitative web survey of 1,000 patients in the United States who were between 18-75 years old, had visited a doctor at least once in the past year, were responsible for paying their own medical bills, and had paid a healthcare bill in the past six months. The responses were balanced by U.S. Census data to be demographically representative. To read more of the research findings, including recommendations for healthcare providers, download the white paper, 2023 Voice of the Patient Survey.