According to a recent Healthcare Finance News survey of 173 senior level finance and operations decision makers, 94 percent of responding executives say improving collections on patient payments is among their organizations’ top three revenue cycle priorities. Improving patient collections is particularly critical for specialists because the can easily reach and exceed having 20 percent of their practice’s potential revenue come from patient payments.Proper patient payment collections require that you keep three things in mind: Time is not your friend, Technology is your friend, A strong process is the foundation of success.Time is not your friendAnalysis on thousands of patient collections efforts has demonstrated that the expected collections once a patient leaves the office fall dramatically. In fact, the expected collections if a patient does not pay within 28 days of the first patient statement fall below 10 percent. This means that you want to limit the amount of money you need to collect from patients and collect the money they do owe on or before the date of service whenever possible.You achieve these goals when you always:
Have the front desk collect and verify patient’s insurance card and demographic information.
Have the front desk verify the patient’s insurance before the case to ensure they do have coverage for the date of service.
Perform pre-certification and never assume the procedure is covered.
Collect the co-pay and co-insurance at the time of the service.
Technology is your friendPerforming the task outlined above on a consistent basis is challenging. Proper use of technology can substantially increase your success rate. Key technologies include:Performance TrackingMake sure your billing/practice management system can support tracking of each front desk person’s quality of information gathering and co-pay collection frequency. If you cannot track and measure these metrics then you cannot improve them. A system that allows the tracking of individual performers and the financial impact of their actions can improve patient payments (and insurance collections) through a combination of merit-based bonuses, targeted training and replacement of poor performers.On-line Insurance VerificationThis is a powerful tool that improves collections for both patient and insurance by insuring that claims go to the proper payer the first time.Automated Calculation of Patient ResponsibilityWith all of the various allowables, multi-procedure rules, deductibles and secondaries, it is quite difficult for a front desk person to know how much they should actually seek to collect from the patients. Often this confusion results in the statement, “Don’t worry about paying today, we will just bill you after the insurance pays.” Your expected patient collections just dropped by 50 percent. You need to deploy a front desk checkout tool that tells the front desk personnel exactly how much to collect from the patient. When this tool is properly utilized, there is no patient balance remaining after the insurance pays (since it has all been collected at the time of service).A Strong Process is the Foundation for SuccessHaving impressive technology and good intentions does not go far unless you have a well designed process that provides proper direction, monitoring, incentives and safety nets. A disciplined process properly allocates your efforts and fully utilizes your technology. Key elements include:
A merit-based incentive system that rewards your best performers. Few things will slow down front desk collection more than a well performing employee seeing a poor performing employee rewarded equally.
Focusing on the activities that have the most potential yield. If you asked your patient two or three times to pay and they have not done so, then they will not pay on the fourth and fifth collection attempt. Do not dilute your efforts on lost causes; turn them over to a collection agency or write them off.
Battling the true enemy: Time. Make sure all patients get a call after the first statements. This is actually your last opportunity to have a reasonable expected yield from patient collections. Moving from sending three statements and a letter to sending one statement followed by a phone call can more than doubling your overall patient collection yield.
Proper application of solid patient collection approaches will lead to higher collections, happier patients (sine they are not still dealing with invoices and collection notices months after their visit or procedure) and a much healthier bottom line.