The Not-So-Obvious Impact Of Holiday Visits To The ED

According to Consumer Reports, the incidents of heart attacks falls, and fires around the home increase during the holidays. [1] And this means a spike in visits to the E.D. around Thanksgiving, Christmas, and New Year’s Eve. Just as E.D. visits increase, so do requests for time off, which makes staffing up for the holiday seasons challenging. Planning for these seasonal variations is a given for hospitals.

But there’s another, less obvious impact from these seasonal spikes that many hospitals fail to prepare for. And that’s the impact on the bottom line.

Bills from visits to the E.D. during the holidays typically arrive during January or February, just as deductibles reset. It’s also the same time that credit card bills from holiday shopping or travel come due. It’s a “double whammy” on patients’ bank accounts, and that means trouble for hospitals seeking to collect. So while staffing up for the holiday season helps meet the seasonal increase in E.D. visits, hospitals also need to protect themselves from the increased spike in collection costs and potential self-pay write-offs from those visits.

Of consumers with single coverage health insurance, 46% have a deductible of $1,000 to $2,999. [2] For family coverage, the cost is even higher:

  • 29% have a deductible of $1,000 to $2,999
  • 26% have a deductible of $3,000 to $4,999
  • 23% have a deductible of $5,000 or higher

$7.5B in patient payments goes uncollected each year. [3]

There is yet another factor that plays into the volatility of post-holiday collections, and that is the international visitor to the U.S. The number of visitors coming to the U.S. each year is growing, reaching nearly 80 million in 2018. Whether to visit family during the holidays or to experience the many holiday celebrations such as ice skating at Rockefeller Center or watching the ball drop in Times Square on New Year’s Eve, it is not uncommon for visitors to experience the same types of accidents others suffer during the holidays—incidents that land them in the E.D.

Foreign patients represent a particularly difficult collections scenario. An article published by Modern Healthcare states: “collecting from overseas payers is typically a unique process in every country and generally very different from the U.S.” [4] And these processes don’t fit neatly within the typical hospital’s revenue cycle for collecting from U.S. payers and patients. Multiple variances exist in coding, regulatory requirements, technologies, and adjudication processes.

Once a bill has gone through the adjudication process, and it’s time to collect from the overseas patient, the challenges continue. Language barriers make communicating balances difficult, especially if billing team members aren’t multi-lingual. Add to this the challenge of converting foreign currencies, and the financial conversation can quickly become frustrating for both billing staff and the patient.

Even when foreign patients want to pay, the transmission of the payment adds another barrier. Wire transfers can be expensive and are usually sent in the patient’s native language. Once received, the transferred funds don’t fit neatly into a hospital’s billing system, so it can be challenging to tie the payment to the account. Another option is using credit cards, but spending limits can mean patients have to use multiple cards for a single bill. And using credit cards across country borders—especially for high dollar amounts—often requires phone calls for verification, adding additional stress on billing staff and further delays in payment.

Whether from a U.S. citizen or a foreign visitor, collecting payments from holiday E.D. visits is more challenging than collecting at other times of the year. Hospitals need to be prepared by having a plan in place to protect themselves from the financial impact. One of the best ways to do this is to partner with experts in international and domestic collections.

Sunbelt Health has more than 30 years of expertise in managing international claims and collections for several of the largest healthcare systems in the U.S. and abroad. Their team of collections professionals is fluent in numerous languages, currencies, and cultures from around the world. Acting as an extension of your hospital, Sunbelt treats patients with the utmost care and respect.

Sunbelt Health has managed more than $1.5B in international accounts receivable, with an average collections success rate of 94%. Partnering with Sunbelt can help protect your bottom line during the holidays—and all year long.