Hospital starts a new POS program for ED collections
Hospital starts a new POS program for ED collections
Teaching staff to ask for money challenging
According to Richard J. Suszek, director of patient financial services at Barnes-Jewish Hospital in St. Louis, the ED has been challenged to improve upfront collections in order to reduce bad debt and, also, to improve screening for Medicaid eligibility and financial assistance/charity care.
In starting an ED point-of-service (POS) collection program, Suszek says that his two biggest challenges are training staff to ask for money and patients not having the ability to pay.
"Our training has been done with scripting, especially for the insured population, and to request financial counseling for the uninsured population," says Suszek. "I am considering hiring a consulting firm to provide patient access customer training for my front-end staff." POS collections will also be part of that training.
Currently, the ED is the only location where POS collection is performed. "Talking with patients is a new role for staff. We have provided training, including scripting. Additional training is planned for new staff and existing staff."
The ED's new POS collection program began on July 1, 2008. "We have not 'pushed' the collection effort," says Suszek. "Our primary target is the insured patient with their typical $100 co-pay. We try and obtain Medicaid or financial assistance benefits for the uninsured patients."
The process for eligibility screening is based on the Medicaid benefit guidelines and the hospital's internal financial assistance policy. The policy basically follows Medicaid guidelines, but with a higher allowable for income and earnings.
Tools have been developed to assist managers with identifying the opportunity to collect, such as patients with private insurance, and give detailed collection results by both registrar and payer.
Previously, the department averaged about $15,000 per month. "This is very low for a facility our size. We see about 250 patients in our ED per day, although we do not ask our high-acuity patients, especially if they are to be admitted," says Suszek.
After the ED POS collection program was implemented, financial assistance increased by more than 30% and Medicaid enrollment increased by a similar margin. "Bad debt has gone down almost 7% in this period," says Suszek.
However, Suszek says that these results weren't solely due to POS collection in the ED, but also to other initiatives in the hospital's Medicaid eligibility department. "It is difficult to quantify the ED impact only, but clearly some of these improvements are due to ED POS collections," he says.
[For more information, contact:
- Richard J. Suszek, Director, Patient Financial Services, Barnes-Jewish Hospital, 4353 Clayton Avenue, St. Louis, MO 63110. Phone: (314) 362-5131. E-mail: [email protected].]
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