by: Jeremy Richey
Prior to 2010, Patient Access leadership would be hard-pressed to discuss copayments, deductibles and out of pocket expenses with healthcare patients at the front desk. Revenue and patient satisfaction seemed to counter-balance each other within healthcare organizations.
Today, this delicate balance has shifted. Over the past eight years, patients have become more and more aware of their individual healthcare plans and their financial responsibility. With the increase of high deductible plans, patients are empowered to shop for healthcare services based on a cost analysis prior to purchasing the plan. This shift provides a new challenge and opportunity for healthcare organizations to increase front-end collections.
Point of service collections encompasses payments posted by the Patient Access team prior to the appointment during scheduling, upon arrival at the front desk or during the patient stay. While collecting from a patient while they are in-house is financially beneficial, a truly successful point of service collections process must begin before the patient’s arrival – specifically around scheduled procedures. These non-emergent outpatient and surgical procedures are especially important because a healthcare organization can provide estimates to the patients prior to any services performed.
Because of the newfound interest in individual health plans, many patients demand price transparency and costs after insurance. Providing estimates to patients prior to service helps reduce financial stress and increases the likelihood of collecting at the time of service by eliminating the “surprise” aspect of a patient bill. Pre-service estimates also open the opportunity for financial assistance teams to screen patients for Medicaid and charity care, which helps reduce net patient revenue.
There are several steps that an organization can take to improve their point of service collections, ranging from strategic initiatives to technological improvements:
- 1. Establish baseline goals: Determine current collection data and set progressive goals for individual departments to obtain in a timely fashion.
- 2. Identify gaps: Complete an organizational analysis and identify areas of improvement.
- 3. Provide technology: Ensure all departments have the necessary technology to complete point of service collections. This includes price estimator tools, credit card machines, quality reporting tools, etc.
- 4. Education: Establish a basic training program for staff members that includes insurance terminology, determination of copayments, and scripting.
- 5. Develop an employee incentive plan: While an incentive plan is not required to be successful in point of service collections it can serve as an employee motivation tool. Creating a plan that is valued by the employee and accepted by financial leadership can help move an organization from “Good” to “Great”. These plans can be developed at a department level or at an individual level.
- 6. Monitor progress: With the development of proper reporting tools organizations can better identify gaps as well as success.