Registrars given a goal, collections rise by 79%
Another 10% increase expected for 2014
Giving registrars a copay goal increased collections by 79% in one year at Lake Forest (IL) Hospital.
"It started out slow," reports Tina Sviland, CHAA, resource coordinator for registration.
When Sviland took over as the supervisor of registration in the ED, copayment collection was not a strong focus. "I saw the missed opportunity for collections," she says. Sviland took these steps:
- Sviland gave each registrar a copayment goal for each month, based on the number of hours they worked.
- She gave the team an overall goal to reach for the month and the year.
- Sviland educated staff on the importance of collecting upfront.
The first year, the department increased collections by 30%. "With practice and consistency, we were up 60% over last year. At the end of the year, we were up 79% over the previous year," says Sviland. The team exceeded the collection goal set for 2013 by 1%, and has set a goal to increase collections by another 10% for 2014.
"The process for setting goals is simple," says Sviland. "I take our yearly goal and break it down into a 12-month period."
The full-time staff all have the same goal, and the part-time staff have goals set based on the number of hours worked. "The team is very focused and will continue to collect even when their goal is met," says Sviland.
Start with the organization's historical benchmarks for collections, and increase these by 10-20% after training and tools are solidly in place, says Katherine H. Murphy, CHAM, vice president of revenue cycle consulting in the Oakbrook Terrace, IL, office of Passport, a provider of technology for hospitals and healthcare providers. "An industry benchmark has been 1% to 1.5% of net revenue," she says. "However, there are so many variables in setting an amount that it is difficult to know the possibilities until you take the plunge."
To make staff members feel successful, Murphy suggests you keep moving the target month by month or quarter by quarter. "If goals are not met, then listen to the registrar's issues and reasons," she says. "Often, there is valuable insight that can shed light for overall improvements."
30% of copays missed
A common obstacle to collections is that patients are unwilling or unable to pay at the time of service.
"They will say to my team, 'Just bill me,'" says Sviland.
There is also difficulty in collecting a patient's copayment when the department is extremely busy. "We run on a tight staff, so that can be a challenge," says Sviland. "My team is diligent in capturing every available copayment. But I do know that when we are busy, a few are missed."
For these reasons, Sviland estimates that 30% of copays aren't collected at the time of service. Before goals were set, however, more than 70% of copays weren't collected.
There are times when a patient will present without any identification or insurance cards, which happens most often when patients are brought in by ambulance. Some patients state that they are not prepared to pay the amount.
"My staff will ask if the patient would like to put anything toward their copayment," says Sviland. "This way, we are able to capture a partial payment. This has been successful for us." (See related story with tips for departments just starting upfront collections, below.)
- For more information on setting collection goals, contact:
- Katherine H. Murphy, CHAM, Vice President, Revenue Cycle Consulting, Passport, Oakbrook Terrace, IL. Phone: (630) 812-2559. Fax: (630) 620-9328. Email: Katherine.Murphy@passporthealth.com.
- Tina Sviland, CHAA, Resource Coordinator Registration, Lake Forest (IL) Hospital. Phone: (847) 535-6404. Fax: (847) 535-7808. Email: firstname.lastname@example.org.