Software got results, only after training

Collections soared to $40,000

After a new price estimator system was implemented at St. Joseph East in Lexington, KY, results weren't seen immediately. These results came only after a significant amount of hands-on training, reports Stephanie Stamper, patient access coordinator.

Before the tool was implemented, registrars only collected known copays and/or deductibles after obtaining benefits. "Even after the tool was implemented, our pre-admission team would obtain benefits, then call the patients to go over those details as well as their demographic information," says Stamper. "But no collections were taking place."

For the first few months, staff members went as far as to run estimates and give them to patients, but they stopped short of actually collecting the entire estimated amounts due. "Then we had a wake-up call during a meeting," says Stamper. "We said, 'We are going over this on the phone and giving patients these estimate letters. Why aren't we actually collecting over the phone as well?'"

Staff discovered that many patients were willing to pay over the phone to avoid the hassle of doing so the day of their procedure, she reports. Collections steadily increased, as more in-depth conversations regarding the amounts due began to take place in pre-admissions, says Stamper. "Even for patients that did not wish to pay over the phone, it increased their awareness," she says. "As a result, other departments began to see an increase in their collections as well, once the patients arrived."

Skill increased

It wasn't until registrars learned how the different benefit plans actually applied that any significant change was seen in overall collections, says Stamper.

"At first, our registrars weren't sure how each piece of the puzzle worked together," she explains.

By using the estimator tool, they could see how the copay, deductible, co-insurance, and out-of-pocket amounts were figured, which gave them the confidence to ask for the money upfront, says Stamper. For example, a patient might need to meet a $500 deductible and a $1,000 out-of-pocket maximum, in addition to a coinsurance of 10%, which means that after the patient meets their deductible, their insurance pays 90%, she says. In this case, the patients would responsible for a 10% payment throughout the year until they have reached the out-of-pocket maximum of $1,000, at which point, most insurances pay 100% of covered services.

"Prior to seeing how these amounts were calculated, some registrars were intimidated," notes Stamper. "They thought the out-of-pocket amount was something they needed to ask for as well. This often seemed overwhelming, as many range from $1,000 to $5,000 or higher." (See related story on individualized training, below.)

Collections totaled $1,300 in the first month of staff collecting over the phone in the pre-admission area and have continued to rise. "As their skill level increased, so did collections," says Stamper. "Collections topped $40,000 in one month, and now average from $25,000 to $35,000 monthly."


For more information on training registrars on price estimator systems, contact:

• Stephanie Stamper, Patient Access Coordinator, St. Joseph East, Lexington, KY. Phone: ( 859) 967-5527. E-mail: