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Successful Point of Service Collections:Why? How?Overcoming the Challenges to SuccessApril 10, 2019Presented by:Rick Rogers, CRCE-I1Objectives for today Set the table for the discussion of need (Industry Outlook) Address the “WHY” in the room (Facility Outlook) Demonstrate the value (Facility Opportunity) Necessary Foundational Changes (Processes and Training) Customer Service driven communication (Facility Image)22Industry OutlookACA Plans Raise Out-of-Pocket CapsRICH DALY, HFMA SENIOR WRITER/EDITORThe findings showed a rising average out-of-pocket maximum among themost popular categories of ACA health plans, compared to a previous analysis.More than a quarter of plans in the most popular category sold ongovernment-run marketplaces have moved their out-of-pocket maximum tothe highest point allowed by federal law, a new analysis has found.Ben Graves, J.D., Director of Research and Compliance at Hays Companies331
Do you seetheproblem?44The Future of Healthcare ?55Facility OutlookSTAFF QUESTION Why Do We Need To Collect At Point Of Service?62
CHALLENGES Research from AthenaHealth examines a key challengefacing healthcare providers today: patient pay, which nowrepresents 18% (and growing) of provider revenue.Patients are responsible for paying more of their medicalexpenses than in past years. This is due in large part to thesignificant increase in high-deductible health plans(HDHPs). According to the AthenaHealth whitepaper, onemillion Americans had an HDHP in 2005. That number hadrisen to 17.5 million Americans by 2014, and as many as 40million Americans are projected to have HDHPs by 2018.InsideARM – Newsletter77Facility OpportunityCLIENT ACTUAL BAD DEBT FOR 2018Magnitude of Missed Opportunity to capture POS cashBad Debt totals for 2018: 34,657,329Average of 2,888,110 per monthAverage of 722,027 per weekAverage of 103,146 per dayAverage of 4,297 per hour(24hr day)88PATIENT BALANCE PROFILE993
CO-PAYS and High Deductible Plans 365 - Business Days per Year 25 - Estimated Average Co-Pay 250 - Patients / Day (avg. Hosp/Clinic)1010Cash Opportunity 2,281,250!1111Processes and TrainingYOU NEED ANSWERS TO THESE QUESTIONSDo wepossess thetoolsnecessaryfor change?Are patientssatisfied withour processtoday andwhy?Whatprocessescan bealtered todayto increasePOS?Whattraining willstaff requireto besuccessful?What does“success” looklike in thefuture? 3 mo,6mo, 1yr?124
How do we get there?“Fundamentally, the patient-access performance driveseverything else in the revenue cycle. If you get things rightin patient access, then the rest of the revenue cycle flowspretty easily.”S. Wolfskill, FHMFA HFMA Magazine13131414PATIENT ACCESS HIRINGINTERVIEWING ABLE TO WORK IN A BUSY AND DEMANDING ENVIRONMENT EXPERIENCE IN PROVIDING EXCELLENT CUSTOMER SERVICE MAINTAIN EFFECTIVE WORKING RELATIONSHIPS (PATIENTS, CO-WORKERS,LEADERS) WILLINGLY ACCEPTS FEEDBACK AND ABLE TO GROW AND/OR IMPROVE FROMFEEDBACK DISPLAYS A PROFESSIONAL AND CONFIDENT APPEARANCE MAKE SURE THE APPLICANT KNOWS HE/SHE IS EXPECTED TO ASK FOR MONEYINVOLVE THE STAFF IN INTERVIEWING CHOOSE STRONG LEADERS TO PEER INTERVIEW NOT ALWAYS LONG TIMERS, USE SOME NEWER STAFF ADVANTAGES TO MORE INFORMAL INTERVIEWS15155
THEY’RE HIRED, NOW WHAT?Training, Training, Training Demonstrate compassion but firmness Teach more than the mechanics Teach patient experienceRemember: asking for money from sick people is not easy! It won’t comenaturally, it will need to be taught.Monitor Results Post team results Quarterly: share individual results Analyze capacity of collections daily Customer service survey resultsContinuing Education1616Performance Metrics1717Together engaged PatientWhen combined, the Financially and ClinicallyEngaged Patient is more likely to:- Understand their treatment- Understand theirresponsibilities- Not be surprised- Meet their financialobligations18186
Denials you will impact these as well! According to AMA, 25-30% of the country’s total health careexpenditure's are direct transaction costs and inefficienciesassociated with the “claim management revenue cycle” The average cost to rework a claim is 25.00 according-HFMA#1 Top Denial Reason Missing information, such as absent or incorrect patientdemographic data and technical errors1919Why Invest the Time to Pre-Register? It assures that your patients’ information is correct. It allows you to be more customer service focused so that insome cases the patient can present directly to the point ofcare. It is the perfect time to ask for co-pays and co-insuranceprior to appointment or set the expectation. Only cost effective way to collect “small balance” co-pays,deductibles and patient portion.Help me(patient) prepare to meet expectations. KEY!20Quality Input Information is FoundationalWrong: “Any change in address since your last visit?”Avoid closed ended questions. Potential answer to this question tells younothing.Correct: “To ensure we have your information correct so we can accurately billyour insurance, we need to confirm a few pieces of information.” ( on yourface.)“In the event we need to send you information via mail, where do you receiveyour mail?”“What is the best phone number to reach you?”(Verify if a cell phone. If so, seek permission to contact this number. (shouldbe on your intake form)21217
Input Information (cont.)Insurance information:Wrong: “Has your insurance changed since your last visit?”Correct: “May I see your insurance card please?”If you can scan or copy, do so. If pre-Registering ask them to bring it.Look for co-pay indicators on the card. Some have dollar amount listedright on them. Use this to your advantage.No employer listed:“Where are you currently working?”Assume they are working versus unemployed.If unemployed, opportunity to engage Financial CounselorSelf-employed?Get business card!Dig for information here and never assume anything.2222Facility ImageIs This You?232324248
BREAKING DOWN COMMUNICATIONSPower of CommunicationAlbert Mehrabian, Professor Emeritus of Psychology, UCLA2525How my kids perceive me at times, I’m sure2626Core Steps of a Successful POS Process Identify the patient by name Identify yourself Thank them for choosing your facility Take care of the registration details Present patient with their financial responsibility and ask for payment in full for the amount owing and deliver options forpayment and ask them which they will be usingPsychological pause – silence is power (Don’t be the first tospeak)Determine the problem/stallFind a solutionClose the “Deal”Evaluate yourself27279
Urgency of the moment drives closure “Hi Mr. Smith My name is Rick. Thank you for entrusting us withyour care today. Your balance due today is 150. For yourconvenience, we accept cash, check or credit/debit card, which willyou be using today?” (Smile on your face ) Acknowledge the patient by name Introduce yourself Thank them for choosing you State your expectation Key!!! – Give them their choices. Of which all support yourobjective.EXPECTANCY–You deserve to get paid!2828Responses to stalls and objectionsPatient: Just send me a bill.You: We request payment at the time of service. This helps us avoid additional costs,which ultimately saves you money. For your convenience we accept cash, check andcredit/debit cards, which will you be using today?Patient: My insurance will pay.You: We verified your insurance and based on your current benefits, thisdeductible/co-payment obligation is yours. For your convenience we accept cash,check and credit/debit cards, which will you be using today?Patient: I don’t have my wallet/purse.You: Did you leave it in your car? Is there someone who can go retrieve it for youwhile we continue the registration process? (You can also try, “We are running a littlebit behind right now so if you get your purse/wallet, we should have you in shortlythereafter.”)Patient: I thought your mission was to care for the less fortunate.You:Yes, that is part of our mission, we have a dedicated representative who will behappy to provide you with additional assistance and information on our financialassistance policy. This would include helping you fill out any forms. Would you like tomeet with them?2929Responses (Cont.)Patient: You never asked for payment upfront before!You: We started collecting these balances as a courtesy to our patients to reducesome of the financial stress associated with a hospital/clinic visit. For yourconvenience we accept cash, check and credit/debit cards, which will you beusing today.Patient: Can I just pay over time?***You: Yes, as a courtesy to you we can set up a payment arrangement; however,we do require an initial deposit which will help to lower your monthly payments.The deposit required for your visit today is . For your convenience weaccept cash, check and credit/debit cards, which will you be using today.Patient: I can’t afford that amount right now.You: How short are you?*** Reference office policy and stay disciplined to it. Stress that this is a courtesy beingextended to them. Don’t become the interest free loan program for your community.This may be a good opportunity to introduce a loan program if your facility has one.303010
“Feel, Felt, Found”Tools to neutralize any situation “I understand how you feel ” (Empathy – KEY!!)“Other people have felt the same way.” (Acknowledge)“Working together, this is what we have found ” (Solve)3131Evaluate Yourself Did I achieve my objective? Did the patient leave feeling better about the “experience”than what they may have expected coming in? What if anything could/should I have done differently? You might need to ask your co-worker to help with this one if youare struggling to come up with options here What did I learn that I can share with the rest of my team sothey are better prepared today and in the future?3232333311
QUESTIONSOur contact info.:Rick Rogers, CRCE-IRichard.Rogers@ar-solutions.biz(888) 302-84443412
According to the AthenaHealth whitepaper, one million Americans had an HDHP in 2005. That number had risen to 17.5 million Americans by 2014, and as many as 40 million Americans are projected to have HDHPs by 2018. InsideARM – Newsletter CHALLENGES 8 CLIENT ACTUAL BAD DEBT FOR 2018 Magnitude of Missed Opportunity to capture POS cash Facility Opportunity Bad Debt totals for 2018 .
