Making the Most of a High-deductible Plan Environment
One ASC achieved 100% cash collection
It was just in one summer month, but Bluffton Okatie Surgery Center in Bluffton, SC, logged a cash collection rate of 100.2%.
“We overcollected and then refunded,” says Terri Mahoney, BN, CNOR, CASC, administrator of Bluffton Okatie. “We collect up front. Refunds seem to be a little higher, but we’re OK with that.”
That percentage rate might be exceptionally high, but the ASC typically collects from patients at a very high rate, Mahoney says. Here is how:
• Always obtain an accurate preauthorization. It takes time and staff effort, but it’s well worth it, Mahoney advises.
“You need accurate information from the physician’s office,” she explains. “When they tell you the CPT code for the procedure, you can get an accurate preauthorization on that CPT.”
This way, the ASC knows what its payments are and how much will be owed out of pocket. If the doctor’s office sends the wrong code or information, it can create a major headache for all involved. The patient might already be booked for surgery, when the accurate cost estimate is discovered, and it means the patient will have to spend more out of pocket.
In these cases, the ASC will offer a payment plan for the patient. Everyone will make this kind of mistake at some time, but surgery centers can learn from their mistakes, Mahoney notes.
• Engage in an up-front conversation with patients. “High deductible plans have increased,” Mahoney says. “We call patients as far in advance as possible.”
The surgery center also uses a software system to help patients see how much of their deductible remains.
“We use software to find out what their financial obligation is three days in advance,” Mahoney says. “You don’t want to do it too far in advance.”
It’s possible a patient’s recent hospital or doctor’s visit had not yet shown up in the system, reducing the remaining deductible. It’s best to wait as long as possible before collecting that information. Bluffton Okatie makes certain all patients know that the center expects them to pay what they owe before or soon after surgery.
“We expect to collect up front everything that is owed in the deductible and copay. It doesn’t always work, but you go from there,” Mahoney says.
Patients should know well in advance that they’ll need to come up with a plan to pay for the procedure. Occasionally, a patient will say the timing doesn’t work for them, financially, she says. At a minimum, the ASC asks patients to pay 50% of their bill on the day of surgery. Then, they have three months after the surgery to pay the remaining bill, Mahoney explains. “The majority of people want to pay their bills. People are pretty good with commitment and being realistic about what they can and cannot afford.”
• Offer simple credit options. In addition to accepting several major credit cards, the ASC accepts payments from a healthcare credit card. Patients can apply for one and use it to pay their medical bill.
“We have noticed a large increase in how many people are using the card,” Mahoney says.
Often, the card will give them a 12-month, interest-free loan. The ASC pays a fee for each bill that the card pays, Mahoney says.
“You have to be careful because the fees for the facility can be quite high,” she warns.
Patients must be approved based on their credit rating. If approved, perhaps they could choose to pay off the balance in 12 months, 24 months, or 36 months. The surgery center is charged a fee that varies according to how long the patient’s repayment time is. The longer the repayment time, the more the credit company charges the ASC.
“We only accept the ones that have to pay it off in 12 months or less,” Mahoney says.
It was just in one summer month, but Bluffton Okatie Surgery Center in Bluffton, SC, logged a cash collection rate of 100.2%.
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