Copay collections at an ASC increased sixfold after the organization made some changes that included staff training and centralized registration.

More than 100 employees at Cooper University Health Care, including patient access employees and insurance verification specialists, attended a class teaching them how to improve the collection process.

“We really shadowed employees and stressed to supervisors on the front end the importance of the change,” says Pamela Konowall, CHAM, assistant director of healthcare access at Cooper University Hospital in Camden, NJ. “We now have a manual for all healthcare access.” Konowall shares what organization employees learned about increasing copay collections:

Patients pay copays up front. Patients receive their first calls about copays two weeks before their scheduled surgery or service.

“If the copay is not collected over the phone, then we make another attempt in this office,” Konowall explains. “The consultation copay is handled by the physician’s office, but procedural copays are handled by our office.”

Strategically word questions about copays. The first call requesting a copayment is crucial. Employees were trained to handle patient responses in a way that will most likely result in a payment. For example, when the first call is made, the staff member tells the patient, “Your copay is X amount of dollars. Will you be paying that by cash, credit, or check?”

“If, instead, someone says, ‘Do you want to pay your copay today,’ the person will say, ‘No,’” Konowall says. “If the patient says, ‘I’m not prepared to pay now’ or ‘I can’t pay — I don’t have that much money,’ then you say, ‘We can take half’ or ‘We can take $10.’

The goal is to collect something, even a small payment toward the copay.

The most common response to a patient saying he or she cannot pay now is to ask, “How much can you pay?” But that will not work, Konowall says. Success is contingent on how the questions are asked and answered.

Another option at the organization is to offer copay deduction to patients who also are employees, Konowall notes.

“That means any Cooper employee can choose to have that taken out of their paycheck. They could have it taken out over three paydays.” Spouses of employees also could see their copay taken out of their spouses’ paychecks. Traditionally, the copays for employees were less than $200, which made the payroll deduction feasible.

Make another attempt to collect three days out. “Three days before the surgery, we make another attempt to collect the copayment,” Konowall says. “We make every attempt to collect it before the patient comes in, but sometimes the patient will say, ‘I won’t pay over the phone. I’ll pay on arrival.’

Each day that a patient has not paid the copay, a listing is distributed to staff in the centralized registration area. The listing tells how much the patient owes. “They’re responsible to make the collection and get the payment before the person comes back to surgery,” Konowall adds.

Keep communication consistent. “We stress consistency in communication, and we try to improve patient understanding,” Konowall says.

“It’s not what you say, but how you say it,” Konowall notes.

Employees are told to use common sense, smile, make eye contact, and use patient names. Employees also say, “Good morning” or “Good afternoon,” maintaining professionalism at all times.

Once employees learned these techniques and became more successful in collecting copays, they were amazed and pleased, Konowall reports.

“People came back to me and said, ‘Now that we know how to do it, it is so much easier,’” Konowall says. “Before, people felt bad about asking people for money, and that has totally changed.”