These collections tips are tried and true

Be natural, not mechanical’

When she first started collecting from patients, Gabriele Thatcher, CHAA, a patient financial advocate at University of Utah Hospital in Salt Lake City, always gave a detailed explanation to the patients on what they owed, then asked if they thought they could pay some of that amount.

"But I have come to realize that each case is different. I need to use a personalized approach each time," says Thatcher.

Thatcher tries to make a personal connection with each patient. "I always try my best to be respectful and empathetic. Once I’ve done that, it’s easy to collect," she says.

To overcome her hesitation of asking for money, for fear of offending the patient, Thatcher reminds herself that patients are expected to honor their financial obligations. "There is nothing wrong with asking for a payment from the patient upfront," she says. (See related story, this page, on the department’s biggest current collection challenge.)

When Ljupka Fuit, a pre-service financial advocate at University of Utah Hospital, collects from patients, she is "natural, not mechanical." First, Fuit reviews the patients’ insurance benefits and their estimated responsibility. Next, she tells the patients how much the insurance is being billed for.

"This way, they have a picture of how small their portion is compared to what the insurance pays," she says.

Lastly, Fuit tells the patients what their 10% discount is for pre-payment in full. Then she asks: "How would you like to take care of that?"

"If the patient hesitates, I explain that by paying upfront the hospital saves money by not sending multiple bills out to them; and that is how we can afford to give the 10% discount," says Fuit. She adds: "If this bill is coming, you might as well pay upfront and save some money."

Before Vernesa Kronojelac, an inpatient financial advocate at University of Utah Hospital, visits patients, she calls their rooms first. "This allows me to make sure that they are in a non-intensive care unit, since they have a phone by their bed," she says. "I never collect from a patient when they are in intensive care."

Kronojelac reviews the patient’s insurance benefit, and mainly focuses on the remaining deductible and/or out-of-pocket cost. "I have had much success in collecting the full out-of-pocket remaining, by pointing out that they will get a 10% discount if paid in full today," she says.

Kronojelac says this final statement helps with collecting: "Either way, you will most likely have to pay your out-of-pocket by the end of your calendar year, with any follow-up services once you have been discharged. This way, you will get a discount by taking care of it now."

Upfront collection needs to be done "in a diplomatic way," emphasizes Glenda Imes, a registration manager at Ochsner Medical Center — North Shore in Slidell, LA. "If we do not present our request in a respectful way, we will hurt the relationship with the patient," she says. Imes says to follow these steps:

• Identify your top collector and have other employees shadow him or her.

• Send employees to other facilities to learn new collection techniques.

• Ensure your staff members know when to escalate, when they can make a decision themselves, and who the contacts are when a financial decision needs to be made.

"If your staff begins to flounder, the patient will quickly pick up on that," says Imes.

SOURCES

• Glenda Imes, Registration Manager, Ochsner Medical Center — North Shore, Slidell, LA. Phone: (985) 898-7053. Email: gimes@ochsner.org.
• Gabriele Thatcher, CHAA, Patient Financial Advocate, University of Utah Hospital. Phone: (801) 581-2207. Fax: (801) 585-2224. Email: Gabriele.Thatcher@hsc.utah.edu.