Set the stage for collections
Collection is "more than just asking," says Katherine H. Murphy, CHAM, vice president of revenue cycle consulting in the Oakbrook Terrace, IL, office of Passport, a provider of technology for hospitals and healthcare providers.
"A full assessment of the staff and of the provider's existing challenges, barriers, strengths, and weaknesses should be done to set the stage and expectations properly," says Murphy. Determine if staff members have access to the information needed to ask for the correct amount, or if they will be uncomfortable asking for money, for example.
Murphy says patient access managers should ask these questions before starting upfront collections:
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Are we new to this process, and does my staff need collection and negotiation training?
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What is the economic climate of the population served?
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How much of the process is or will be automated?
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Are determining insurance eligibility and benefit information automated and integrated?
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Is the eligibility information uniform and rich in the content needed for collection activities?
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Is there easy access to procedure pricing, historical data, and contract terms needed to determine the patient liability?
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How easy is it to calculate discounts?
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Do we have an automated estimator tool?
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Is the cashiering process and payment plan process easy and quick?
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Does the collection goal include dollars collected on existing open accounts?
Managers need to determine the best time to ask for the money is crucial, and this varies on a case-by-case basis. "Point of service is also the 'point of stress' or 'point of crisis' for the patient," says Murphy. "You also have to assess if you should collect."
About 50 million people are uninsured, notes Murphy, but many are eligible for Medicaid or other charity and financial assistance programs. "This makes collection a slippery slope without automated tools focused on determining a patient's ability to pay," says Murphy. "As recently as 2011, nearly two-thirds of Medicaid-eligible children were not enrolled." She recommends these approaches:
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Collect money yourself.
Managers who expect staff to collect from patients should periodically get involved in taking a payment themselves, advises Murphy. She recommends going out to the registration area and collecting money yourself.
"Try doing it by phone in scheduling. Show the staff you really do understand their challenges," she says. "They will love you for it."
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Always celebrate if collection goals are met or exceeded.
"Food is a universal way to celebrate," says Murphy. Other ideas include: Pass a traveling trophy between registration areas, give staff members a recognition pin or flower, or give a handwritten thank-you note to top collectors.
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Give staff incentives.
"A reward and incentive program is really important to the folks in the hot seat," says Murphy. "It doesn't have to be costly, either."
Pick a day of the week for cookies, bagels, fruit bowl, a potluck lunch or dinner, or coupons for a sundae or frozen yogurt from the cafeteria, Murphy says.
"We once had a 'white elephant' gift exchange in the middle of summer at our pizza lunch. This added levity and helped clean out our closets," she says.
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Be visible in registration areas.
Take a walk through registration areas, suggests Murphy. Ask staff if things are in working order, and ask whether they have had any recent challenges or successes they would like to share. Pass around a basket of candy as you talk to them.
"Sometimes my areas were so busy I could barely say hello, but I know that my staff saw me," says Murphy. "It meant a lot to all of us."
During off shifts, weekends, and holidays, Murphy would occasionally pop in to say hello or at least call staff to let them know she was thinking of them.
"Even during the night shift, call your ED registrar," she says. "Let them know that you have not forgotten them and that they are important members of the team."
