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7 dos and don'ts of patient collections

Is your ASC struggling with patient collections? If so, you're not alone. As patient financial responsibility has increased over the past several years, with the rise of deductibles and co-pays, so has the challenge of collecting what a patient owes for treatment.

While all healthcare providers should be focused on ensuring they are paid for services rendered, this is particularly important for ASCs. The ASC industry has experienced tightening reimbursement and increasing costs (e.g., staff, equipment), resulting in leaner margins. What patients owe for their portion of surgical care could be the difference between whether a procedure makes or loses an ASC money. Even collecting a portion of a patient's financial responsibility can turn a little profit into a loss for procedures with lower reimbursement.

To improve your likelihood of collections success in a manner that reduces the potential to harm patient satisfaction, follow these seven dos and don'ts.

1. DO: Collect payment before surgery. It's best to collect as much money as possible before a procedure. Collecting after surgery can prove difficult as patients may be coming out of anesthesia or distracted by post-op discomfort. The moment patients walk out your ASC's door, the chances of collecting in full decline.

2. DO: Determine what patients owe before surgery. Develop a means to at least estimate the cost of a patient's care. This will provide you with a figure to target for pre-operative collection.

3. DON'T: Wait to share the estimate. For most patients, the closer it gets to the day of surgery, the more nervous they become. Finding out the day before their procedure that they have a large medical bill coming may put them into a panic that could result in their canceling the procedure. Try to give at least a few days' notice.

4. DO: Be prepared to discuss the estimate. Staff who call patients to share the estimate should be able to explain the figure. Despite the multi-year trend of increasing deductibles and co-pays, patients are often surprised to learn that they owe as much as they do for their care, in part because most people are paying a lot more for premiums than they used to. There may be an incorrect assumption that higher premiums correlate to lower out-of-pocket costs for care.

Staff must have the knowledge to explain how the ASC determined the estimate and even be able to answer questions about insurance and premiums. If staff are unable to speak to these issues, it could leave patients feeling frustrated. Remember: Patient satisfaction is not just tied to the surgical outcome. A perceived bad experience with your ASC at any point during the episode of care, including discussions about payment, could result in poor satisfaction scores.

5. DON'T: Neglect staff training. Patient collections — discussions about them and the acts themselves — aren't always easy. For patients living on tight budgets, a surgical bill of $500 — on top of any days they need to take off from work for their care — may feel overwhelming. Staff should receive adequate training on how to appropriately discuss patient financial responsibility and collect payments. This training should cover not only what to say but how to say it. Language should be kept simple, with jargon avoided or, if used, explained. In addition, these discussions should be approached sympathetically as financial matters are often sensitive subjects.

6. DO: Offer payment options. According to the May 2018 "Report on the Economic Well-Being of U.S. Households in 2017" report from the Federal Reserve Board, four in ten Americans cannot cover an unexpected expense of $400. Some patients may be able to cover the costs of all their care up front, but many others will likely desire a way to spread out payments.

By offering flexible financial solutions, such as a secured loan to cover surgical costs, patients and ASCs can get what they need. Through this innovative approach to payment, select lenders are now funding providers very soon after patients undergo procedures. The lenders manage all collections activities, with patients receiving loan packages that fit their budgets. The results: Patients undergo the procedure they require and pay it off over a period that better meets their needs. ASCs, most importantly, receive expedited patient payments. As bonuses, they will likely experience enhanced revenue cycle performance and may even witness case volume growth.

7. DON'T: Let your commitment to collections waiver. It is imperative that you view patient collections as a serious matter — one that requires detailed policies and procedures not unlike those associated with your ASC's critical clinical activities.

If staff do not follow collections processes, it can result in money left on the table and unhappy patients. Staff performance should be monitored, tracked and benchmarked. Hold ongoing meetings with collections staff to discuss challenging situations, highlight success stories and identify opportunities for improvement. By keeping patient collections in the spotlight, you will help improve your ASC's financial performance and may even see notable improvement in overall patient satisfaction.

Randy Bishop (rbishop@surgicalfunds.com) is a partner with Surgical Funds, which facilitates patient financing solutions to supplement out-of- pocket expenses for ASC procedures.

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