Industry Insights: The cost of patient co-payments in South Africa

Industry Insights: The cost of patient co-payments in South Africa


As much as we try to avoid them, patient co-payments (co-pays) are a reality in South Africa. How you decide to handle co-pays at your practice, can have a huge impact on your practice’s bottom line. 

In this article, we look at the average size of co-pays in South Africa by speciality, how this affects your revenue and provide 4 ways to collect co-pays and keep your patients. 

What are co-pays really worth? 

Below is a table of the average co-pay expected per patient by speciality* from 2017 – 2019: 

Co-pay expected per patient by speciality

At first glance, it might not seem like a huge amount, but by way of example, let’s take a look at what this really equates to for a General Practitioner practice. A GP had an average co-pay value of R24.33 per patient in 2019. If that GP saw 350 patients per month, the total patient co-pay that they would need to collect is  R8 515.50 per month, or R102 186.00 for the year. 

If they only manage to collect 70% of patient co-pays each month, they would be losing R2 554.65 in revenue per month. This might not seem like a significant amount of money at first glance, but over a year, it equates to over R30 000, which could be a staff member’s salary or an investment in upgrading offices and equipment. 

The point is that co-pays add up and can make an even bigger difference to your practice revenue depending on your speciality. To see a more extensive list of average co-pays by speciality in 2019, click here.

4 Ways to collect co-pays and keep your patients 

As can be seen by the data and the graph below, patient co-pay proportions increased substantially between 2017 and 2019.

The surge in co-pays, annual increases in medical aid membership fees and the current economic climate is making it harder to collect from patients. This said, there are still some practices that are overcoming these challenges. In fact, our data shows that many of our clients have 0% uncollected patient co-payments. 

To help you become one of these practices, we’ve put together the top 4 strategies to implement for collecting co-pays:  

1. Focus on front desk 

Your practice staff are your number one resource for collecting co-pays. Do they know how and when to collect, and what your practice payment policies are? 

It pays, in the long run, to invest in training your staff on how to collect payments in a manner that is polite, professional and efficient. At the end of the training or retraining, your staff should know the importance of maintaining up-to-date patient medical aid and payment details and checking whether the patient has available funds when making an appointment. It’s also absolutely critical that your staff are able to speak to patients about your practice’s financial policy and make them aware of possible co-pays. For more about collecting patient payments, click here.

2. Set financial expectations ahead of the visit – inform patients of financial policies

We touched on this above, but it’s worth expanding on. Healthbridge data has shown time and time again that those patients who are informed of any payments due before and directly after consultation, are far more likely to settle than those that have had nothing said to them and are presented with an unexpected invoice a day or 2 down the road. 

In addition to upskilling your staff on your payment policies, it’s also a top priority to communicate your payment policies to your patients. The best way to do this is to incorporate your payment policy into new patient forms or medical aid verifications that your patients must read and sign in agreement. The policy should be written in plain language and clearly outline the patient’s responsibilities. Above and beyond that, your staff should be able to answer any question your patients might have. 

For more about developing a sound patient payment policy, click here.

3. Use technology to your advantage  

It’s been proven that using technology to submit claims in real-time, invoice patients before they leave the practice and sending follow up SMS payment reminders reduces bad debt and improves the collection of co-pays. More than that, your EMR should be able to tell you which medical aid plan your patient is on so that you tailor your treatment plan accordingly. 

Technology isn’t just a question of digitising processes. It presents numerous opportunities to open communication with patients and answer their questions about co-pays and benefits immediately. If you haven’t yet taken advantage of the benefits of an EMR, get in touch with us to talk about your options.  

4. Offer payment plans and avoid the collection agency

You’re entitled to be paid for your services rendered and even if you are maintaining best practice when it comes to collections, there will be patients who simply don’t pay. Collection agencies are one way to collect outstanding money but this should be considered a last resort. The goal is really to have your staff so well versed on collecting payments and communicating with patients that a collection agency isn’t necessary. 

More than that, if you consider the cost of using a collection agency versus the amount you are collecting, it’s probably worth your while to offer patients a payment plan to settle their invoices. The benefits of payment plans are that you are working towards building a stronger relationship between your practice and the patient. There may be extenuating circumstances for a patient to not pay in which case, there’s an opportunity to afford them more time to pay while keeping them as a long-term patient. Secondly, if you are using available automation and digital tools to not overburden your staff with admin, you can manage collections in house without the expense of an external agency. 

For a guide on how to talk to patients about co-payment, click here

So, while co-pays are an unavoidable reality, effective collections can be a reality too. For more about how to use technology to improve your practice finances, click here to have a Business Consultant call you back. Healthbridge – a nationwide leader in healthtech for over 20 years. 

*Based on a data sample of over 5 000 medical practices in South Africa.
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