Stop hard feelings about incentives
Stop hard feelings about incentives
Take a team approach
Giving incentives to individual registrars who met collection goals at Martin Health System in Stuart, FL, seemed like a good idea at first, but it didn't work out too well, according to Carol Plato Nicosia, CHFP, CPAM, MBA, administrative director of corporate business services.
The problem is that "several people touch the same account," Nicosia says, so it was difficult to determine who should receive credit for collecting funds. A registrar might do a lot of work determining the amount to collect at pre-registration, for example, but the patient might end up paying a different registrar on the day of service.
"Clearly, there are people who do a lot of important work who don't necessarily get to collect the cash," she says. "If they're working on authorizations, you want them to be part of the bonus."
In addition, says Nicosia, registrars were "gaming the system" by trying to register patients who they knew would owe more out of pocket, she says. "If it is more money in their pocket, they are going to find a way to make sure it comes to them," she says.
Incentives are now given to all patient access employees if the goal is met, which Nicosia says has been much more successful. "We want everybody to try to collect as much as they possibly can," she says.
All FTEs included
If a department doesn't make its monthly collections goal several months in a row, employees begin to doubt their ability to collect, says Berdia Thompson, admissions supervisor at Hendrick Medical Center in Abilene, TX.
"They lose motivation and their attempts to collect also begin to decrease," Thompson reports.
If an overall trend of lower collections is observed, employees are given in-services to improve their collection skills. "We also refer to our dashboards to see if a smaller patient volume has affected our collection opportunities," says Thompson. "During the 2010-2011 fiscal year, our department made its collection goals 10 out of 12 months."
Originally, only registrars who collected the money from the patients received the incentive, which led to some patient access employees "picking and choosing" the patients they wanted to register because of the amount due, says Thompson.
"This created uneasy feelings among the other employees," she says. "People who were behind the scenes felt they played an important role in the collections process."
Now, all full-time patient access employees receive the incentive unless their base pay already is higher than their colleagues', such as insurance verifiers who calculate the patient's out-of-pocket responsibility, says Thompson.
"Without estimates, the registrars would not know what to collect from the patients," says Thompson. "Temp employees also get an incentive; however, their portion is calculated at a different percentage."Giving incentives to individual registrars who met collection goals at Martin Health System in Stuart, FL, seemed like a good idea at first, but it didn't work out too well, according to Carol Plato Nicosia, CHFP, CPAM, MBA, administrative director of corporate business services.
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