The patient lending platform (PLP) model is increasingly being seen as a source of fiscal aid in a time of razor-thin profit margins.
“First do no harm” is a tenet often heard in healthcare. In today’s environment, the same promise should certainly be extended to the payment arena: do no harm to the patient’s pocketbook.
In a recent Modern Healthcare article, it was stated that CEOs are struggling with the status quo. This could be considered true across the healthcare continuum. It is a constant challenge to maintain a healthy cash flow in the industry. The challenge has only escalated in light of COVID. Typically, healthcare providers work on extremely small profit margins. These challenges have become even greater for rural health providers, as well as critical access providers.
Stepping outside of the status quo and exploring opportunities to provide innovative and efficient care without having to expend countless hours on payment collections might sound like a tale from an alternate universe. However, it can become reality when a patient lending platform (PLP) is introduced to streamline the process of payment and collections. A PLP is a relatively new concept that has offered relief in the healthcare environment, particularly in rural areas and/or small communities.
PLPs partner with healthcare providers and community banks to reduce the financial burden on patients while quickly offering cash solutions to providers. The transactions allow providers to receive immediate payment, while patients are allowed to pay back the bank in time-based installments at low interest rates. Patients are essentially in control of the loan terms, which allow affordable repayment of healthcare costs. PLPs allow patient-provider financial transactions to run “in the background,” thereby promoting efficiency and tremendous cost savings as the burdensome collection work typically done by staff is offloaded to a local bank partner.
For banks, this can provide a unique lending opportunity: an additional interest revenue stream with a low customer acquisition cost. When it comes to patient collections, revenue cycle management (RCM) companies are an integral part of the overall process. If a claim is not fully adjudicated, RCM works with the insurance company to remediate issues, as appropriate. It is not uncommon for a well-versed professional in the RCM space to support a patient’s understanding of their bill and/or Explanation of Benefits (EOB). Even after a claim has been fully adjudicated, RCM can lend its expertise to ensure that it is adjudicated correctly. An inaccurate bill is certainly not considered an infrequently encountered event.
In February 2020, CNBC reported that 32 percent of American workers have healthcare debt, and 28 percent owe more than $10,000. On average, 55 percent of uncollected healthcare revenue is a patient’s responsibility. Almost half of those surveyed defaulted on their medical bills. As health insurance deductibles and co-insurance rates continue to increase, so does the financial and administrative burden to hospitals.
Within healthcare, we have broadened our horizons, moving toward artificial intelligence, natural language processing, computer-assisted coding, and other technological advances. Claim adjudication is routine in healthcare organizations. However, when the automated process uncovers a problem, human intervention is required, which only prolongs the time until the healthcare organization is paid.
Several case studies have shown a decrease in accounts receivable and an increase in patient and employee satisfaction after implementing a PLP. Perhaps it’s time to look at alternative solutions for bridging the worlds of hospital revenue collection and affordability for patients. The knowledge, expertise, and attention to detail a RCM professional offers adds immeasurable value in streamlining the PLP and improving the overall healthcare experience.
Programming Note: Listen to Susan Gatehouse today on Talk Ten Tuesdays, when she co-hosts the weekly Internet broadcast with Chuck Buck at 10 a.m. EST.
I had planned a different topic for this week, sequencing sepsis, based on feedback from my last article, but an article about OpenEvidence rolling out
EDITOR’S NOTE: The author of this article used artificial intelligence (AI)-assisted tools in its composition, but all content, analysis, and conclusions were based on the
Please log in to your account to comment on this article.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Happy HIP Week! Sign up to win free access to our 2026 Coding Clinic Update Webcast Series! Click here to learn more →
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
