With POS collectors, pave the way for 'stars'

After patient access staff at UNC Health Care in Chapel Hill, NC, began receiving bi-weekly reports on how much they collected, their performance began to improve.

"We were surprised that when we began publishing the bi-weekly dashboards, those who were struggling didn't struggle any longer," says Jeness J. Campbell, administrative director with the Office of Revenue Cycle Management.

Campbell identifies her top collectors with a biweekly staff dashboard that is produced in conjunction with the pay period. "The dashboard shows the total dollars each staff member has collected," she explains.

Campbell sends this data to staff on a biweekly via e-mail and posts it in the work area. She also divides the overall dollar amount collected per staff member by the total number of visits checked in, to calculate the average dollars collected per visit checked-in. "This statistic allows us to most accurately compare across all of our staff, to more easily identify our consistent top collectors," says Campbell.

The data allows her to open the lines of communication with staff members, whether their performance was stellar or sub-par. If it's stellar, she asks whether they did anything differently and why they think they got better results. "If it's sub-par, there may be something going on that we need to know about," says Campbell. "There may be barriers that management can help remove to improve their performance."

Intermittent incentive programs are held, with the top three collectors awarded for total collections as well as average collection per visit. "The awards include differing increments of gift cards to the gas station or restaurant of their choice," says Campbell. Incentive program results are published in weekly team e-mails, adds Campbell, and leaders send personalized thank-you cards to top collectors.

Incorporate incentives

"We find that our top collectors consistently use a tone and words that work," says Campbell. "Therefore, we use those words as the standard for all staff. Top collectors may assist by demonstrating for their co-workers."

Campbell says the phrasing that has proven most successful is "UNC requires an estimated deposit of [$] for today's service. How would you like to pay today?"

"Our goal is to have the top collectors do real-time, shoulder-to-shoulder mentoring," she says. "Currently, we are just monitoring the top collectors, noting the ways and words that seem to work better than others."

Amanda Gilmore, patient access supervisor at Legacy Emanuel Hospital in Portland, OR, says co-pays "are an automatic part of our registration process." Members of the patient access staff collect co-pays for outpatient diagnostics, pediatric surgery, adult surgery, and the emergency department. They set goals for co-pay collections in each of these areas, based on the volume and expected revenue generation per visit/procedure/surgery, says Gilmore.

Co-pay collection is included as a performance requirement on the department's monthly and quarterly employee evaluation, she says, and a monthly status report lists all departments with a breakdown of amounts collected. "We have incorporated incentives for the collection of co-pays with drawings, gift cards, and recognition for the highest collectors," she says.

ID missed opportunities

Each area has its own "missed opportunities" for co-pay collection, says Gilmore. "Many patients are not completely informed about their insurance co-pays for multiple services," she says. For example, most patients in the outpatient diagnostic department aren't aware of co-pays for procedures such as electroencephalogram, EKG, and ultrasound.

If a complete authorization was not obtained for a surgical procedure, there might be an undocumented deductible or co-pay requirement in the account for the patient access team to reference upon registration, Gilmore says.

Pre-registration, pre-authorization, and pre-verification teams work to obtain the necessary demographic information, insurance authorizations, and verification of amount due, she says. "This supports the patient access department's collection at the time of registration," says Gilmore. "They also serve as a capture point when speaking to the patients prior to arrival."

Sources/Resource

For more information on improving point-of-service collection, contact:

Jeness J. Campbell, MBA, Administrative Director, Office of Revenue Cycle Management, UNC Health Care, Chapel Hill, NC. Phone: (919) 966-7029. Fax: (919) 966-1167. E-mail: jj_campbell@unchealthcare.org.

Margaret Trudel, Middlesex Hospital, Middletown, CT. Phone: (860) 358-6864. E-mail: Margaret_Trudel@midhosp.org.

• "The Revenue Cycle: Big Picture" and "POS Collections: Skills for Success" are part of the RC360 training curriculum and the Revenue Cycle Certification Program. Fore more information, contact The Academy of Healthcare Revenue, Milwaukee, WI. Phone: (888) 700-5223. E-mail: email@academyrcm.com. Web: www.academyrcm.com.