EXECUTIVE SUMMARY

At Novant Health in Winston-Salem, NC, patient access was falling a little bit short of its collection goals.

“We were about 1% — about $50,000 — shy of our goal. We put together a task force, with an all-hands-on-deck approach,” says Elkin Pinamonti, MHA, CHAM, assistant director of onsite access for the health system’s greater Winston-Salem and northern Virginia markets.

The group consisted of supervisors and managers in admissions and financial counseling. “We started with labor and delivery,” says Pinamonti.

First, the task force brainstormed about some of the barriers to collecting upfront from this particular group of patients. These barriers included:

• Not contacting patients early enough for them to prepare for the cost;
• Discrepancies between what patients expected their insurance would cover and their actual benefits;
• A need for scripting to notify patients of their responsibility, while showing compassion and desire to help.

“The way it was set up before, financial counseling was primarily responsible for getting the estimate letters to the patient,” says Pinamonti.

Financial counselors did make an effort to give patients an idea of what their insurance would pay and what their out-of-pocket costs would be. The problem was that it didn’t happen consistently.

“It really wasn’t flowing well,” says Pinamonti. “We were missing some opportunities.”

$674,000 in a Month

Pinamonti decided to get one of her best registrars involved in the collections initiative. The registrar had a solid understanding of financial discussions and collections. “This was just the push we needed,” says Pinamonti.

The registrar worked in the outpatient setting, but quickly became comfortable with the inpatient process. She was tasked with contacting labor and delivery patients about two months before the due date. During the phone call, the registrar had two goals: to help prepare people for their financial responsibility, and to ask for a deposit.

“Truly, just asking ahead of time and learning how to explain the benefits to the patients was what helped,” says Pinamonti. In the first month of doing this for all labor and delivery patients, the registrar collected $160,000.

“It was really amazing to give somebody autonomy and let them run with it, and to see that take life,” says Pinamonti. “The registrar’s success was contagious.” The department’s net revenue the following month was $674,000 — a record for collections. Electronic work queues are set up so patients are contacted at the right point in time. “We don’t want to do it too soon or too late,” explains Pinamonti.

‘Happiness Factor’

Registrars in various areas are eager to get involved in the successful initiative. “Onsite leadership has discussed the initiative with the team,” says Pinamonti. “It’s not just one person now. We have four or five people who want to jump in with both feet.”

Patient access leaders at other facilities in the health system are now looking at implementing the same process for their labor and delivery patients.

“We’ve had an extremely successful ROI on this, and we are on track to continue increasing,” notes Pinamonti. The same approach is now going to be implemented in other areas of the hospital. However, some registration areas, such as the ED and outpatient setting, have additional barriers to collections. For one thing, registrars in these areas have less experience collecting than their inpatient counterparts.

“It might take a little longer to see results. But hopefully, we will see the same kind of success,” says Pinamonti.

For Pinamonti, the successful initiative is strong evidence of the power of participatory leadership: “When you do that, you have a lot more of that happiness factor. People want to come to work.”

SOURCE

• Elkin Pinamonti, MHA, CHAM, Assistant Director, Onsite Access, Greater Winston-Salem, Northern Virginia Markets, Novant Health, Winston-Salem, NC. Phone: (336) 718-4935. Email: epinamonti@novanthealth.org.