Training is key to collecting pre-surgery
Greensboro, NC-based Cone Health Systems recently revamped its processes for upfront collections and reduced denials for scheduled surgeries and outpatient appointments by creating a new department named the PreService Center.
"Some benefits of the PreService Center include educating our patients prior to the visit of their benefits, copays, out-of-pocket amounts, and co-insurance responsibility," says Sebrena Johnson, team lead specialist. "Due to the training, staff are more confident in their new roles. They have a better understanding of the necessity of upfront collections and reducing denials."
The PreService Center staff receives ongoing training on customer service and effective collection processes, including verification of insurance and using credit card machines. "We are noticing successful results are coming from educating the staff and making sure staff are prepared with accurate information prior to contacting the patients," says Johnson.
The PreService Center is collecting for outpatient and inpatient surgeries and outpatient scheduled appointments for MRIs, CT scans, ultrasound, and vascular studies.
Employees are more comfortable in collecting because they can explain the information to the patient with greater confidence.
"Even though our collections have increased immensely, there is still opportunity to bring in more revenue," says Johnson. "It is an ongoing training and learning process."
Having your billing office track the percentage of anticipated copays and visit fees that are collected pre-surgically will help you and your staff members know how they are responding to education and collection activities, sources say.
Have staff learn from top collectors
One of the most powerful tools to use when requesting monies from a patient is silence, says Aaron Robison, CHAA, a patient financial advocate at University of Utah Health Care in Salt Lake City.
When asking for a copay, he says, "It looks like you have a $40 copay due today. How would you like to pay it?" He then waits patiently for the patient to respond.
"Waiting for patients to break the silence, instead of doing so myself, usually results in them responding with a form of payment," he says.
Robison says if he were to break the silence first by saying, "Are you able to take care of this today?" "then the patient has been given an easy out of the responsibility, by simply saying that they cannot pay anything at that time."
Robison suggests looking within the department for someone who successfully collects from patients, so others can learn from that person. "Having a fellow coworker give tips or advice on how to better collect from patients could possibly work better than an outsider," he says. "Your coworker knows the intimate workings of the department."
Working alongside a successful collector can also give a team member phrases or methods that they didn't know about before, at a very low cost to the department, he says.
Robison says that the simpler your approach, the more likely you will collect from a patient. "Both tone of voice and eye contact can make or break your opportunity for getting anything from a patient," he adds.
By maintaining eye contact and voicing your request in a steady and firm manner, Robison says you are communicating to the patient that this request for money is part of their responsibility and participation in their care. He uses these words: "Your insurance has determined that for a certain procedure your responsibility will be XX."
By telling a patient this information, Robison reminds the patient that the insurance company makes the rules as to what amount the patient pays. "The healthcare provider doesn't determine what you will owe. That's up to your coverage plan," he says.
