Staff must be prepared before collecting copays
Much less rework is needed
Reduced collection cost and better patient satisfaction were the two major benefits of collecting copays at the time of service that were identified by patient access leaders at Cooper University Health System in Camden, NJ.
These steps were taken by the project team, which had representatives from patient accounts, patient access, pre-registration, physician billing, and training, before point-of-service copay collections were implemented:
1. A vendor was selected.
"Our final vendor selection was driven by the need for a robust, web-based application which would interface directly with our current registration system," says Randall Smailer, manager of patient access/quality assurance.
The system also needed multi-faceted reporting options and the ability to offer a patient portal for online payments. (See related story below on the department's implementation of online bill payment.)
2. Detailed policies and procedures were written, and a comprehensive online training program was created.
A subgroup of the project team was charged with creating policies and procedures. The training department took on the task of developing the online training.
"This was considered the most efficient way to train a large number of staff, without requiring them to leave their work sites," says Smailer.
3. Every point-of-service site throughout the health system was visited by the "communication team," a subgroup of the project team.
"The primary concern on the hospital side was a change in culture, in having to ask patients for a copay prior to a hospital-based service," says Smailer. "This is the norm at a physician's office, but relatively new for a hospital procedure."
Some staff members also were concerned about using the software application, but they saw it was easy to use once it was presented to them in training. The team gave employees an overview of the copay collection project, covering objectives, benefits, training, copay determination methods, and collection tools to be utilized.
"Users are given the option of reviewing service type benefits from online portals, or for more complicated procedures, using an online price estimating tool linked to our managed care contract," says Smailer.
4. Since the new software allowed credit cards to be swiped from any user's computer, a count was taken and swipe pads were ordered.
5. The new process was thoroughly pilot tested.
This step ensured that the process was relatively problem-free before being introduced throughout the health system.
"We wanted to monitor the effects of using the new application in all stages of the revenue cycle," says Smailer. "So we piloted it in pre-registration, the hospital cashier's office, and cash applications in the hospital billing office."
6. The new copay collection process was rolled out to most hospital-based service areas.
Departments new to collecting copays were provided with safes and petty cash to make change.
"The physician side of the health system began with a phased rollout strategy, as they replaced their old credit card machines with the new point-of-service collection software," says Smailer.
Less rework needed
Employees now enter payments with ease, and manual processes such as the need to send hard copies of payment logs have been eliminated.
Because the new process transitioned patients who were expected to pay the hospital cashier over to paying at their point of service, there has not yet been a notable increase in collections, reports Smailer. "We are just starting to venture into new areas that didn't collect copays previously, such as heart station, sleep study, gastro, and pulmonary," he adds.
However, duplication of efforts and redundancies have been greatly reduced. "At the five-month point into our implementation, we are very pleased with the results," says Smailer.
Before the point-of-service collection tool, each area responsible for copay collection compiled a daily copay log and forwarded it to cash applications in the hospital billing office. Payment posters manually entered every payment.
"Since our new process has been implemented, front-end staff can effortlessly collect payments," says Smailer. "These are batched nightly and automatically posted to the patients' accounts the following day."
Get ready! Your patients soon will pay bills online
At Cooper University Health System in Camden, NJ, patients no longer need to make a special trip to the hospital cashier to pay their bills. Instead, they have a "one-stop shopping" experience.
"We have installed point-of-service collection areas where the patient will be receiving their treatment," reports Randall Smailer, manager of patient access and quality assurance. "We are now beginning to expand to new areas that we were not previously collecting copays."
Five months after implementing a point-of-service collections tool, Cooper University Health System is taking the next step. The organization's patient portal will allow patients to pay bills online, view current and past statements, and update demographic and insurance information.
The patient portal team started by reviewing other hospital portals created by its vendor, along with those of similar healthcare facilities in the area. "This helped us to envision what our portal should look like," says Smailer.
Customizations were added, such as sample hospital and physician statements and the ability to review past billing history. "As the portal is developed, team members test for ease of use, typos, and any broken links or inconsistencies," says Smailer.
All patient billing statements will include a link to the portal when it goes live in late 2013.
"We expect to see increased patient satisfaction with the ability to pay bills online at their own convenience; and a decrease in cash application payment posting, since online payments will self-post," says Smailer.
• Randall Smailer, Manager, Patient Access/Quality Assurance, Cooper University Hospital, Camden, NJ. Phone: (856) 361-1642. Fax: (856) 968-8461. Email: smailer-randall@CooperHealth.edu.