Show Me the Money
Healthcare is a business and like any other business, it takes money to run it. While most of the money in healthcare comes from insurance companies and is paid after the fact, it is important to recognize that there is a good portion of money that can be collected upfront from a new payor, the patient. Whether self-pay or insured, almost all patients have a financial responsibility, hence the need for point of service (POS) collections. Implementing a successful POS collections strategy reduces bad debt and increases cash flow allowing an organization to fund the services necessary to take care of the healthcare needs of their community. So how do you start bringing in the cash? Some secrets are estimates, scripting, and pre-service collection calls.
What’s My Financial Obligation?
Determining a patient’s financial obligation is the first step. Whether the at the time of scheduling, pre-registration, or registration, this can be done by creating an estimate either manually or by using an estimator tool. For insured patients, the key to the estimate is knowing the specific charges as well as the contracted allowable to calculate the cost to the patients. An estimate provides the copay, coinsurance, deductible met/not met, and out of pocket max to show how the patient financial responsibility was determined based on the insurance plan. For self-pay patients, the estimates can be created using the specific charges and the self-pay discount to calculate the total cost to the patients. Estimates are a win-win; they provide the information the registrars or financial counselors need to confidently explain to the patients how much they owe and why. Estimates also provide a sense of confidence to the patients that the registrars or financial counselors know what they are talking about when they ask for payment.
Scripting Is Key
Having the “money” conversation with a patient, especially when the patient is not feeling well, is not easy. Scripting provides guidance to the staff and helps them to establish a comfort level when having to ask patients for payment. Standardizing the way that staff asks for payment sends a consistent message to the patients and aids in setting the expectation of paying prior to services. Simply adding the word “how” to the beginning of the question “would you like to pay today” makes a huge impact in that the patient is not being asked if they want to pay, but “how” they want to pay, thus implying that payment is required. Equipping the staff with scripting also enables them to anticipate what questions or pushback the patients may have and be able to respectfully rebut and secure payment.
Pre-service Calls = Good Patient Satisfaction
Pre-service collection calls help to create an awareness of any financial responsibility patients may have. Using staff with collections experience and who are comfortable in asking for money, to contact patients prior to services for payment can significantly increase upfront collections. The calls provide good customer service by 1) notifying the patients of their cost share ahead of time so they can plan on how they are going to pay for the services and 2) by identifying those patients that cannot afford the healthcare services they need and being able to provide financial assistance to them. Taking care of payments pre-service also helps to minimize the wait time when the patients arrive at the facility for services, thus increasing patient satisfaction.
POS Collections Keeps the Doors Open!
Point of service collections are vital to the revenue cycle and financial health of an organization. Collecting upfront and having the “money” talk prior to services being rendered help to increase cash flow, decrease bad debt, and appropriately identify charity. Healthcare is a business. Getting paid for the services they provide enables healthcare organizations to continue to keep their doors open and grow to meet the demands of the community they serve. Show me the money!