Here are five steps to increase patient collections at ambulatory surgery centers from Jim Devitt, an expert in healthcare revenue cycle management.
1. Devise a defined collections policy. It's crucial for surgery centers to have a defined collections policy that patients understand even before they arrive at the surgery center. If the patient knows what their responsibilities are and when payment is due, the ASC is more likely to collect.
"The ASC should have a written set of policies and procedures about handling the account from cradle to death," says Mr. Devitt. "There are some people coming in with $5,000 deductibles and you must have a policy from the minute they walk through the door on how you are going to handle collections."
Place importance on working with the patients for quick and easy payments. "It can be done in a nice way that keeps it clear and simple for the patients," says Mr. Devitt. "Define what is acceptable and what is past due. You may see some practices that keep billing statements 10 months after services are delivered, and that's a problem. Focus on patient responsibilities and the actionable steps you will take to collect."
In the policy, define how many written notices or letters patients will receive, how returned mail is handled and when statements are due. If you are too busy to manage the revenue cycle and go after delinquent patients, consider outsourcing these services.
2. Revise billing statements. Many surgery centers don't invoice patients properly or include unclear wording in their business statements. One of the biggest downfalls in billing statements is the breakdown of the aging budget; people see this and assume the payment isn't due until the last payment date.
"Shift statements to leave out the aging and include a specific date for the next payment," says Mr. Devitt. "Many practices also say the payments are due upon receipt. Patients think this means they can pay whenever they want."
Some surgery centers have trouble tracking down patients who move. These centers can use an address service request — a free service with the post office — which forwards the statement to the patient's new address. The post office will update you when the patient moves so you'll have the new address as well.
3. Go after late payments early. Surgery centers need to pursue late payments aggressively. The defined collections policy should outline a certain set of actions that occur when payments are late and ASCs must take these steps immediately.
"If you look at the research, the more you contact a person on the front end for payment, the better chance you have of getting paid," says Mr. Devitt. "It's unacceptable to send a statement every 30 days. You need a system with more contact early on in the process."
ASCs can't always have in-house operations pursuing these patients, but there are affordable systems available to automate this process. Ideally, ASCs should contact patients up to five times per month for payment. If this is not realistic, ASCs should consider outsourcing to focus on these collections.
4. Make appropriate phone calls for payments. The recent Consumer Protection Act prevents practice from contacting patients via cell phone unless they have specific permission to call that number. The problem is that people can switch cell phones or numbers and then the debt collectors are calling someone else. Become familiar with the Consumer Protection Act and set goals for the patients who you are able to call.
"Most people sit down and make the phone call and say 'You owe us money,' when someone picks up," says Mr. Devitt. "Instead, have a set of steps to reach a specific goal, like a payment plan, and discuss the patient's expectation of pay. There is a whole cascading process here that you should have in place. When dealing with the patient, make a connection and actively listen to them for clues about their situation to develop the best payment plan possible."
When going after delinquent payments, the ASC staff must be compassionate but also have a solution. Help the patient feel like they are not alone — there are several others who hare having difficulty paying — and work with them on the solution.
5. Train staff in money collection. Staff members at the surgery center should have special training to understand the rules and regulations of payment collection. If a mistake is made, the ASC must admit to it and work with the patients to make it right.
"The worst thing that could happen is the ASC tries to twist the mistake so fault falls on the patient," says Mr. Devitt. "If you make a mistake, admit it and correct it. Otherwise they could write a negative review on social media websites. Keep your patients happy and you'll drive increased patient volume."
If you are unable to collect from the patient, bring in a third party experienced at collecting this type of debt. "For some patient debtors, as soon as the third party is implemented, they will pay," says Mr. Devitt. "Sometimes people become very savvy in how to deal with payments and they know their credit won't be hit until they see the third party involved."
Third party contractors may accept a flat rate for working on the claims or take around 33 percent of collections.
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