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Four ways to improve your ability to collect
Fewer resources, service discounts, high deductibles, transparency, increased market competition, and increases in the uninsured population. These factors make it "ever so critical to collect during the upfront processes," says Katherine Murphy, CHAM, director of access services at Nebo Systems, a subsidiary of Passport Health Communications Inc. in Oakbrook Terrace, IL.
To improve staff's ability to collect:
When hiring, don't forget to include collection in the job description.
"Keep in mind that future hiring practices should include seeking candidates with skill sets that are key to this responsibility," says Murphy.
Obtain buy-in of external department staff.
It is not helpful to the process if a registrar is charged with collecting emergency department copayments when the department's discharge practice is to bypass the registrar or cashier charged with this initiative.
Murphy says she once worked with a provider that developed an incentive program for the emergency department clinical staff. Each time they escorted the discharged patient back to the collection area, their name was entered into a weekly raffle drawing.
Post signage for walk-in patients.
As they arrive, these patients are given the opportunity to read the expectation of payment. "Perhaps begin with asking for the full amount due, but then ratchet down to a minimum deposit due," suggests Murphy. "Remember, many providers now offer self-pay and prompt-pay discounts. This should always be discussed with the patient."
Without automation, notes Murphy, it can be difficult to drill down to the amount owed quickly and accurately, which negatively affects patient throughput.
Offer online training to staff.
Peter Savini, vice president of revenue cycle management at Catholic Health Initiatives, says that a comprehensive online training course was recently developed, due to an increased emphasis on front-end collections at his organization.
The goal of the training is to improve customer service, and answer the question: "How do we have this conversation with patients at the point of service?"
"Each of our market-based organizations will identify representatives within their access area who should be required to take the course," says Savini.
The course was developed in-house based on feedback from local and national access staff at the organization's facilities. Each facility gave input about the tools that would be most helpful in overcoming existing barriers representatives faced when engaging patients in dialogue as they paid at the point of service.
Savini says that by and large, the biggest barrier was one of "culture."
"We have many small critical access hospitals and mid-size sole community providers," says Savini. "Traditionally, our access representatives did not engage in these types of conversations in the past. Simply asking them to begin to do so, without providing necessary staff training and communications to the community, would not be setting ourselves up for success."
The training includes scripting, role-playing, quizzes, and tests. The number of access staff trained will depend on the size of the facility. "On average, we expect two to five representatives to be trained per facility," says Savini. "We can track this through our in-house e-learning tools."
This way, patient access managers can keep track of which staff took the training course, and which did not but were required to based on their position. "The scores of the representatives are also tracked," says Savini. "This allows us to provide additional training where scores indicate it may be needed."