7 Strategies for Successful Patient Collections – Q & A with Elizabeth Woodcock

October 31, 2017

By: Elizabeth Woodcock

According to MGMA, one in every four healthcare dollars comes from patients. And with the rising amount of patient financial responsibility, it’s critical for healthcare providers to focus on their patient collections strategy.

Elizabeth Woodcock, MBA, FACMPE, CPC, one of the nation’s top experts in medical billing and collections, recently shared her 7 tips for successful patient collections. In case you missed it, here’s a written summary, and here’s a link to the on-demand webinar. Elizabeth also sat down with us at ZirMed and answered the top questions on how to maximize patient collection performance. Check them our below.

Do you believe we should call patients about balances?

A: If you have the resources to do so, by all means. However, this is generally not a high opportunity for reward. Therefore, I would suggest considering training your staff to request balances if and when patients call about other issues. You cannot deny care (or treatment), however, it’s a great idea to ask.

Can you discuss the suggested percentage of overall receivables that each category should have (for both insurance and patient receivables)? I want to set realistic targets for my billing department.

A: This is dependent on your payer mix. The higher the mix of uninsured and commercial payers, the higher the percentage of patient financial responsibility as a percentage of your total receivables. If you have a preponderance of Medicare, Medicaid and Workers’ Compensation, you may have very little patient receivables. Without a firm understanding of the payer mix, it’s difficult to cite percentages. However, you could estimate what the mix should be based on your payer mix.

Would a verbal suffice for consent for recurring payments?

A: This is an area that I would address with your vendor, and then verify with your attorney.

I am from a Home Health Agency and we do not see patients at our office.  What do you suggest in getting co-pays paid when we actually have no eye to eye contact with the patient?  I have to use the US Postal Service, so what would be a good statement to add on an invoice to make these people pay their bills?

A: You may consider a “roving” payment model whereby your staff have a credit card swipe device, such as those used by a mobile food truck or taxi drivers. In terms of statements on the invoice, be sure to include a due date. In my opinion, a positive statement works well: “Thank you for choosing us for your home health care. We appreciate your payment, Ms. Patient!”

As a walk-in urgent care clinic, how do you propose we check benefit eligibility and financial responsibility without slowing down the process to get the patient seen?

A: Real-time eligibility (RTE) is a great tool; this is typically offered by your clearinghouse. Be sure to choose a solution that provides the greatest breadth and depth of payers. I have found that some clearinghouses have solid functionality, but do not have all of the payers in their database. You want to choose a solution that offers real-time eligibility with all of the payers with which you participate. Train your staff to perform this function if the patient “calls ahead,” and upon his/her arrival. Another “best practice” is to integrate RTE with your self-check-in process. Thus, when patients “check in” online for your center, the RTE is a component of that process.

Do you have any suggestions for ambulance services being able to collect any money up front?

A: This is a difficult situation, however, there may be an opportunity to carry a payment mechanism in the vehicle. This would be very similar to a taxi driver, using a tablet connected to a mechanism to swipe a credit card. Another idea would be to engage the facility(ies) to determine if you can co-finance a position in the registration area to perform on-site collections. This is increasingly common in ambulatory surgery centers – the facility and professional fees, and hospital-based imaging centers – the facility and the professional fees. I would recommend engaging an attorney who is familiar with EMTALA, to provide suggestions for this area of your business.

What is your opinion of charging interest? Is it worth all the work or not?

A: There are several considerations, the first of which is to ensure that your practice management system can automate the process during the dunning cycle. Calculating interest manually is a waste of resources. You’ll also need to integrate the consent from patients during your registration process, in order to comply with Truth in Lending regulations. In my experience, practices use a flat fee ($5, for example), more effectively. Typically, the money – whether it be interest or the flat fee – is most often not collected. It, however, is used as a collection tactic. The patient is told, “If you pay the balance, we’ll waive the fee.”

What is your opinion of implementing payment plans for outstanding balances?

A: I think that payment plans offer a great alternative for patients who cannot pay at the time of collection. As we discussed on the webinar, be sure to deploy successful tactics when setting up payment plans, to include, but not be limited to asking the patient: “how much more time do you need?”; establish a minimum installment ($25 is recommended); and develop a method to designate payment plans in your practice management system, separate from balances. You may also wish to contract with a third party, such as a credit card company that specializes in medical debt.

So your advice is to steer clear of using the USPS and go electronic?

A: That is correct; migrate to online bill payment, and transmit statements via email (with a link to a secure website) – and/or integrate the process via the patient portal or other API platform that patients can use. Of course, there may be a portion of patients for whom this electronic communication method will not work. However, it is likely that the vast majority of transactions will be online in the next 5 to 10 years so it’s a great time to start migrating towards this today.

To learn more about ZirMed’s solutions that could improve your patient collections strategy, click here.

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