Prioritizing Pre-Service in Healthcare

Household bills, for some people, are a struggle to pay—no matter the situation. Add into this the current swirl of the COVID-19 crisis, with its impact on jobs, incomes, and the economy, and an unexpected or surprise medical bill can be especially painful. Knowing that patients have been furloughed, laid off, or have lost their insurance coverage, health systems must reevaluate their approach to the patient financial experience. That approach must compassionately support patients while at the same time increase patient loyalty, engagement, and cash flow. 

A self-service digital platform is one way to help support those initiatives. Such a platform supports pre-service for patients, giving them the ability to see their care costs and provide payment options upfront. Pre-service has gained ground over the last year as price transparency requirements loom on the horizon, sending health systems looking for ways to lessen confusion for patients and increase clarity and convenience around costs of care. 

[Watch the TransUnion Healthcare webinar “Change Your Engagement Approach to Improve and Empower Pre-Service Patient Payments”]

Pre-service coordination is meant to increase efficiency for patients and office staff. It doesn’t just cover appointment details and verify demographic information, it also includes time spent educating and informing patients of their financial liability and options. Part of that time now includes providing care estimation costs, meant to take the surprise out of bills. Patients know upfront what their service will cost before they arrive, and they have the opportunity to pay for that service in full, in part, or to make payment arrangements. 

But the devil’s in the details. Each patient has different needs and requirements and should be treated as an individual. So how does a health system provide its patients with an estimate of care? And do it in a way that is efficient for staff, minimizing time pressures? For instance, how can health systems help a patient who has the ability to pay by creating a payment arrangement that gets the balance paid quickly post-adjudication? And how does the approach change for a patient who might have a high balance, but much lower ability to pay? One size does not fit all, after all. 

We believe health systems should start with a digital self-service platform that enables pre-service activities that encompass the clinical and financial process, end-to-end, for patients and health systems alike. As Kristin Burns, director of product at VisitPay explains, “Targeting the right people with the right types of offers helps them stay engaged. It also provides needed relief right now. In a very deliberate way.”

[Read the Aite Impact Brief for details on how VisitPay and TransUnion Healthcare “create the right payment offer for each consumer and communicate through the preferred consumer channel with the proper messaging.”]

Recognizing that patients want out-of-pocket estimates prior to service, patients are presented with options at the outset. Patients receive copies of their estimate upfront and an easy-to-understand EOB post-adjudication, which in turn contributes to payment plan fulfillment and increased patient satisfaction measured by a net promoter score. Burns explains, “We feel it’s really important to be flexible and understand the market that we’re working in when we’re determining what those offers are going to be.” Our unique partnership with TransUnion Healthcare develops a personalized set of payment options based on propensity to pay scores

While estimates are meant to take the surprise out of costs, they aren’t foolproof. When the final balance comes through, VisitPay has developed a way to correct the difference between the estimate and actual costs with auto-correct, or auto-heal. It’s meant to provide patients with transparency and clarity as well as keep patients engaged in the payment process along the way while automating work that would otherwise fall to the revenue cycle team.

Options on how to pay are also important. Some patients might be perfectly comfortable with a text message for a $3,500 balance. That’s how they prefer to be notified. Others may be completely shocked by that and would expect to get a phone call instead. Understanding patient communication preferences is key.


Pre-service is just one way health systems can better serve their communities. With it, they can better meet patients where they are and provide them with the flexibility and convenience they need. Not only does it result in improved cash flow, patient satisfaction, and increased organizational efficiencies, but it provides patients with the compassionate approach they need right now.

Healthcare needs a new end-to-end patient financial approach. TransUnion and VisitPay have it.

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