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8 Ways ASCs Can Improve Patient Collections

Caryl Serbin, president and founder of Serbin Surgery Center Billing, offers eight ways ASCs can improve patient collections.

1. Collect as much upfront as possible. It used to be that out-of-pocket expenses were just a small portion of the bill, but with the growth of high deductible policies, making patients pay $3,000 or even $5,000 in expenses, some fully insured patients may actually owe all or most of the bill. Before the service is rendered, be aware of any restrictions limiting collection of fees by your state or the specific payer. Collections before surgery save your ASC the expense of post-surgery collection calls and billing statements.

2. Be polite but firm. Show the patient how much is owed and how much should be paid before surgery. "Be courteous but firm," Ms. Serbin says. "The ASC often must educate patients on their contractual coverage. Explain the insurance policy is a contract between the patient and their insurer and the patient must meet certain financial obligations dictated by this contract."

3. Obtain surgeons' support. In pre-surgery office visits, surgeons may be advising the patient, "You don't have to worry about the bill until after the surgery is done." This may be all well and good for the surgeon's office, which will see the patient again, but the ASC has only a one-time visit so up-front collections are crucial. To prevent misunderstandings on how fees will be collected, provide the physician's office with the ASC's financial policies and procedures.

4. Handling deductible levels. The amount owed on the deductible varies depending on other services the patient has already paid for. This amount can usually be determined by contacting the insurer. Sometimes patients insist they have paid more of the deductible than the insurer has reported, which is possible if they had a recent office visit or ancillary service. Give them the benefit of the doubt, and say: "If you'll bring in your receipts showing how much of your deductible has been met, that's not a problem."

5. Educate patients about co-insurance estimates. When providing patients with an estimate of how much co-insurance they could owe, explain why the final amount may differ from the estimate. Co-insurance, which is the patient's share of the total bill, usually expressed as a percentage, is difficult to estimate correctly beforehand because the surgery may go differently than planned and costs could change. Taking the time to educate patients prior to surgery prevents confusion when they get the final bill.

6. Set up a payment plan. When patients can't pay the full amount of the deductible and co-pay before surgery, suggest a short-term payment plan, preferably no longer than 90 days. The growth of high-deductible policies has necessitated more use of such arrangements. Monthly payments can be made automatically through patients' credit cards or bank accounts. The payment plan should include an initial down payment covering the costs to be collected before surgery.

7.  Consider using a healthcare credit company. These companies pay the provider the full amount owed, minus a fee, and the patient pays the loan back through a payment plan. This a good option for patients as long as their income level and job security meet the company's requirements. Because of the recession, healthcare credit companies are taking a closer look at patients' qualifications.

8. Promissory note is last resort. If no other options are available, the ASC can consider having the patient sign a promissory note and pay the center directly. Again, a down payment should be collected prior to surgery covering the costs due at that time. ASCs normally don't charge interest for direct payments. "They don't want to look like a commercial banking institution," Ms. Serbin says. But she stresses this option is "a last-ditch effort" because enforcing payment plans is very difficult.

Learn more about Serbin Surgery Center Billing.

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