POS collections up 53% after changes

Collections increased by 53% from Fiscal Year 2011 to 2013 at University of Pittsburgh Medical Center (UPMC) after patient access departments implemented an action plan focusing on the emergency department (ED) and imaging services.

"In order to be successful, we had to engage our front-line staff with our vision of sustaining collections and looking for solutions for the long term," says Georgina Trunzo, executive director of patient access services for UPMC's Hospital Division. These steps were taken:

1. Managers taught staff to use payer eligibility technology.

"Knowing what to collect was critical," Trunzo says. "We continually provide front-line staff with the most current and accurate patient copay information."

At check in, the system provides the front-desk staff with the copay amount that is due from the patient, based on the insurance benefit plan on the patient's account. "This facilitates upfront collection by providing staff with the information they need in real-time," says Trunzo.

2. Staff members were taught how to ask patients for money.

Front-desk staff members complete a required training curriculum that includes how to ask for payment, as well as posting of any and all patient liabilities.

Patient access leaders developed online training for collection of co-pays, and the organization's system was changed so that outstanding patient balances are visible to front-desk staff at the point of payment posting. "This provides an additional opportunity to ask for payment while the patient is present," says Trunzo.

3. Goals were established for point-of-service (POS) collections, with daily, weekly and monthly reporting to track progress.

"Accountability was key," Trunzo says. "Point-of-service collection information is electronically published, with trending of results by business unit."

On a monthly basis, cash collection reports are published electronically and include amounts due and collected, along with collection percentages. "This allows operations managers to monitor upfront collections specific to their worksite and to published benchmarks and expectations," says Trunzo.

4. Patient access leaders worked with imaging and ED advisory leadership across the UPMC system.

"Each facility patient access director has open dialogue with their clinical colleagues," she says. "On a regular basis, we share top collectors, attainment of goals, or areas to improve."

In the ED, clinical colleagues also are engaged with directing patients to the discharge window by giving patients discharge instructions and asking them to stop at registration.

Two EDs are piloting handheld devices that allow staff to collect directly at the bedside. "This has improved patient satisfaction in that it eliminates a stop at a discharge window," she says. "Patients like to have someone take their credit card real time in front of them and not have additional worries about information being compromised."

Patient access leaders worked with clinical colleagues in imaging services in these ways:

• Patients are informed at the point of scheduling that if a copay is due, it will be collected at the time of service.
• Patients are given the choice to pay online from their home or at the point of service.
• Patients are reminded of their copay obligations as part of automated appointment reminder calls.

"We also collect both physician and facility copays at our front desks for our hospital-based clinics, as well as at those physician sites that have imbedded ancillary services," she says.

Patient access provided clinical areas with scripting and educational materials utilized by access personnel to increase their awareness level of patient liability and collection.

"This will become even more critical in the very near future, with more patients having out-of-pocket liability," says Trunzo.

SOURCE

• Georgina Trunzo, Executive Director, Patient Access Services, Hospital Division, University of Pittsburgh (PA) Medical Center. Phone: (412) 647-0159. Fax: (412) 647-2160. Email: trunzog@upmc.edu.