RCM Providers and HDHPs: Solving Collection Challenges with Multichannel Conversational AI

The rise of High Deductible Healthcare Plans (HDHPs) has placed a significant financial burden on both patients and healthcare providers. With patients responsible for a larger portion of their medical bills, Revenue Cycle Management (RCM) providers face delayed payments and growing collection challenges.

Multichannel Conversational AI is an innovative solution that automates patient communication across multiple platforms—such as voice, SMS, and email—improving patient engagement and accelerating payment collections.

In this blog, we’ll explore how conversational AI can help RCM providers manage the complexities of HDHPs. Can AI be the solution RCMs need to streamline operations and boost collections? Let’s find out!

Need help with HDHP collections? Let Convin’s AI help—Book a demo!

Why High Deductible Healthcare Plans (HDHPs) Are Rising

High-deductible healthcare Plans (HDHPs) are becoming more popular due to their lower premium costs, especially as healthcare expenses rise. According to a Mercer study, over 55% of U.S. workers were enrolled in HDHPs by 2023. 

According to the American Medical Association, this trend is driven by rising healthcare costs, which grew by 4.5% annually, reaching $3.8 trillion in 2022. HDHPs offer lower premiums, but patients must cover more out-of-pocket expenses until their deductible is met.

1. Why Employers Prefer HDHPs

HDHPs are cheaper for employers to provide. Large organizations spend an average of $84 per employee per month on HDHPs compared to $132 for Preferred Provider Organization (PPO) plans, representing a 37% cost reduction. 

This makes HDHPs a preferred option in private-sector employment. Additionally, HDHPs provide multichannel communication flexibility, allowing patients to choose healthcare providers more freely than Health Maintenance Organizations (HMOs).

2. The Patient Perspective: Savings and Flexibility

Patients benefit from HDHPs due to their Health Savings Account (HSA) eligibility, which offers tax-free savings on healthcare expenses. This flexibility empowers patients to make more informed healthcare choices while controlling costs. 

HDHPs allow patients to save for future medical needs, and unused HSA funds can be carried over annually. This feature makes HDHPs more attractive, especially when paired with holistic healthcare conversational AI that provides clear guidance on billing and payment options.

3. The Burden on RCM Providers

As HDHP adoption grows, Revenue Cycle Management (RCM) providers face increasing challenges in collecting self-pay dues. With patients responsible for paying larger upfront medical bills, collections become more complex, lengthening revenue cycles and delaying cash flow. 

RCM providers must also deal with patients who struggle to understand their insurance and deductibles, which results in increased billing disputes.

4. The Role of Multichannel Conversational AI in RCM

Multichannel Conversational AI is an innovative solution that streamlines patient communication and helps RCM providers manage collections.

1. Automates Multichannel Communication: Multichannel Conversational AI engages patients across various platforms, such as voice, SMS, email, and chatbots, ensuring seamless outreach.
2. Proactive Payment Reminders: Automatically sends payment reminders, helping RCM providers manage self-pay dues effectively and reducing delays.
3. Simplifies Bill Explanation: AI clarifies billing details, improving patient understanding and minimizing disputes, which is crucial for conversational AI in healthcare.
4. Facilitates Payment Plans: Helps set up payment plans, improving collection rates for healthcare conversational AI.
5. Boosts Efficiency: Automates repetitive tasks, reducing administrative burdens and accelerating cash flow for conversational AI for healthcare providers like Convin’s AI Phone Calls.

Convin’s AI Phone Calls (AI Voicebot) is an industry-leading solution. It automates tasks such as bill explanations, payment follow-ups, and setting up payment plans. 

Using conversational AI healthcare systems, Convin's AI Phone Calls improves collections by 60%, boosts customer satisfaction by 27%, and offers scalable engagement across channels. These benefits are crucial for RCM providers seeking to manage rising HDHP-related challenges and streamline their operations.

The Impact of HDHPs on RCM Providers and Early-Out Collections

For RCM providers, the rise of HDHPs has led to increased self-pay patients, making collections more difficult. Patients now handle a larger share of medical bills, resulting in delayed payments and increasing accounts receivable for RCMs and External Business Offices (EBOs).

1. Increased Patient Self-Pay Responsibility: Patients with HDHPs need help to meet high deductibles, leading to deferred payments and straining RCM operations. The rise in self-pay dues forms a significant part of outstanding balances, creating financial pressure.
2. Lengthened Revenue Cycles: Delayed patient payments extend revenue cycles, creating forecasting and liquidity challenges for healthcare conversational AI providers that rely on timely payments for operational stability.
3. Higher Administrative Burden: With more self-pay balances, RCM teams must communicate more multichannel with patients, explaining bills and following up on overdue accounts. This increased workload drains resources and time.
4. Increased Billing Confusion and Denials: Patients must understand their insurance benefits under HDHPs, leading to more disputes and claim denials. Conversational AI healthcare systems, like Convin’s AI Phone calls, help streamline patient communication, reduce billing confusion, and speed up collections.

Given the growing complexity of payments under HDHPs, multichannel conversational AI is essential for managing patient communication and accelerating collections efficiently.

How Multichannel Conversational AI Streamlines Early-Out Collections

Multichannel Conversational AI is a transformative tool for RCM providers and EBOs navigating the complexities of HDHPs. Engaging patients across multiple platforms—such as voice, SMS, email, and chat—ensures efficient, consistent, and scalable communication.

1. Proactive Patient Engagement: Conversational AI in healthcare allows providers to automate payment reminders, explain bills, and offer flexible payment plans. This proactive communication reduces missed payments and keeps patients informed.
2. Seamless Multichannel Communication: Multichannel communication across phone, chat, and email ensures every patient is included, allowing RCMs to scale their outreach without overwhelming staff.
3. 24/7 Availability: Healthcare conversational AI operates around the clock, enabling patients to resolve billing queries or set up payment plans anytime, improving collection timelines.
4. Automated Reminders and Follow-ups: Conversational AI for healthcare automates tasks such as sending payment reminders, ensuring patients stay on track, and reducing reliance on manual follow-ups.

Multichannel Conversational AI transforms how RCM providers manage early-out collections by offering proactive, consistent, and automated engagement. This will ultimately lead to faster payments and improved cash flow.

Boosting Efficiency with Conversational AI for Healthcare

Conversational AI in healthcare streamlines collections and boosts overall operational efficiency for RCM providers by automating repetitive tasks, reducing staff workload, and enhancing patient engagement.

1. Automating Routine Tasks: Multichannel conversational AI handles routine tasks like bill explanations, setting up payment plans, and answering FAQs. This allows agents to focus on resolving complex issues, boosting productivity, and minimizing burnout.
2. Faster Payment Processing: With options like on-call payments and text-based payment links, healthcare conversational AI speeds up the payment process, reducing friction and improving cash flow.
3. Lower Training and Staffing Costs: Since AI handles common inquiries, RCM providers can operate with fewer staff and reduce the need for extensive training, cutting costs while maintaining high efficiency. Automating processes allows teams to allocate resources more strategically.
4. Improved Patient Engagement and Satisfaction: Patients benefit from the convenience of AI-powered systems that allow them to resolve issues quickly without waiting on hold. Personalized, conversational AI interactions improve satisfaction, leading to more timely payments and better patient retention. 

Convin’s AI Phone Calls have demonstrated significant improvements, including a 27% boost in customer satisfaction, making it a vital tool for enhancing both collections and patient relationships. With conversational AI for healthcare, providers can streamline collections and operations, creating a more efficient and patient-friendly revenue cycle management system.

Convin’s AI Phone Calls: Empowering RCM Providers to Overcome HDHP Challenges

Convin’s AI Phone Calls are designed to help RCM providers tackle the growing challenges associated with HDHPs. Their wide range of features enhances collections and improves patient engagement.

1. Multilingual Support: Convin’s LLM is trained with data in 35+ languages and can engage patients in multiple languages, ensuring inclusive communication across diverse populations.
2. Bulk Outreach: The AI handles thousands of patients simultaneously through scalable multichannel communication, including voice, SMS, and email.
3. AI-Powered Payment Assistance: Provides real-time billing breakdowns, payment links, and payment plans via voice and text channels.
4. Proven Results: Convin’s AI platform has reduced operational costs by 60%, increased conversions by 10x, and improved customer satisfaction by 27%.
5. Automated Follow-Ups: The virtual agent handles routine follow-ups and reminders, reducing the need for manual interventions.

By implementing Convin’s Virtual Agent, RCM providers can streamline collections, lower administrative burdens, and improve efficiency, making it easier to handle the complexities brought by HDHPs.

Experience the efficiency of AI-driven collections—book a demo now!

Leveraging Multichannel Conversational AI to Solve HDHP Challenges

The rise in HDHPs is reshaping the healthcare landscape, making it increasingly difficult for RCM providers to collect patient dues. By implementing Multichannel Conversational AI, RCMs can streamline patient communication, automate payment reminders, and reduce administrative burdens. As healthcare providers continue to adapt to these changes, Conversational AI offers a scalable solution that improves collections and enhances patient satisfaction.

See how automation can transform your RCM—Book a demo now!