Scripting is especially helpful for reluctant collectors, but it can come across as rehearsed and robotic. To be successful, registrars should do the following:

  • Listen carefully to what the patient says.
  • Don’t assume the amount is too high for the patient.
  • Pause after telling the patients what they owe.

Pair Best Collectors with Struggling Ones

At Ann & Robert H. Lurie Children’s Hospital of Chicago, some registrars feared confrontation or being put on the spot if they asked for money. Others correctly stated what the patient owed, but their statements appeared to be scripted.

“Representatives must engage the consumer in conversation, versus simply stating, ‘This what I see, and this is what you owe,’” says Robin Speaks, MSHSA, CHAM, director of admitting.

To address this, the department pairs one or two reluctant collectors with an experienced collector to “show them the ropes.”

Here are some tips that the high-performers shared:

  • Practice the art of conversation.

“Rattling off a bunch of scripted words that do not fit the scenario is time wasted, non-valued, and a dissatisfier to the consumer,” says Zander Davis-Washington, director of ambulatory support at Lurie Children’s outpatient clinics.

Instead, registrars carefully listen to what the patients are saying, so they can engage in a true conversation.
“The registrar may refer the patient to appropriate resources such as financial counselors, social workers, or patient relations,” Davis-Washington adds.

  • Always make eye contact with the patient.

Eye contact allows the registrar to “read” the patient’s facial expression. “If there is high anxiety or worry from the consumer, deflect the conversation for a moment, but come right back to it,” Davis-Washington advises.

  • Wait for a response.

“Do not give consumers a choice not to pay before you have heard their response, just to keep the line moving,” Davis-Washington says.

  • Say different things, depending on the division.

Depending on the area the registrar works, he or she must be able to engage in financial discussions on facility, physician, surgical, and anesthesiology fees.

“All of the right tools and resources must be in place so representatives can have an informed and intelligent conversation with the consumer,” Speaks says.

Since “one-size fits all” scripting doesn’t work, patient access leaders came up with a list of situations and effective responses.

“What applies to one division does not necessarily apply to another,” Speaks explains.


  • Zander Davis-Washington, Director, Ambulatory Support, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-3145. Fax: (312) 227-9801. Email: ZDavis@luriechildrens.org.
  • Robin Speaks, MSHSA, CHAM, Director, Admitting, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-1231. Fax: (312) 227-9710. Email: rspeaks@luriechildrens.org.