The economy is only slowly starting to turn around, and Medicare reimbursements are taking a hit as well. It's no wonder, with the future looking so grim, that ASCs are nervous and anxious about how to remain competitive and financially viable. One way ASCs can maintain profits is ensuring ASC services are always paid in full. Here are five proven tactics for ensuring full payment from patients.
1. Always verify benefits. Don't assume prior to surgery that your patient understands how his or her insurance works, says Sandy Berreth, administrator of Brainerd Lakes Surgery Center in Baxter, Minn. Before your patient arrives at the center, call them to make sure they understand how their insurance plan works and they have the benefits they say they do.
"[Patients] just assume that their insurance is going to pay for this, and they don't understand that if they have an 80/20 insurance plan, they're going to owe 20 percent of a bill that [can total in the thousands]," she says.
2. Help patients understand the bill. Rose Eickelberger, RN, director of surgical services for two affiliated orthopedics ASCs, Summit Surgery Center and Beacon West Surgery Center, both part of Beacon Orthopedics in Cincinnati, which is operated by Practice Partners in Healthcare, says her surgery center's staff is spending more time educating patients about their bill.
"The problem is that patients don't understand their health insurance," she says. "The high deductibles are new for them." Her office calls every patient before surgery to explain the charges and provide an estimated cost, though patients are warned the amount is only an estimate. "We are working off the op notes so we don’t know exactly what procedures are involved," she says.
3. Follow up with patients who haven't paid. Whether your requirement payments to be made in one installation or you accept payment plans that let patients pay their bill in portions, you need to make sure you know the status of every patient and every payment, Ms. Berreth says. Sixty days after the third-party payor has paid their portion of the bill, you should call patients to investigate why they haven't paid.
"My collector can be like a dog with a bone," Ms. Berreth says. "She is very diligent about calling, and she has a list of people she calls on an almost daily basis." You might feel guilty for bothering people about money — especially when so many people are unable to pay their bills — but remember that you deserve to be paid for procedures, and sometimes you might be dealing with a patient who just needs to talk through their bill with an expert.
4. Include educational literature with your statements. Michael Storch, national client representative for Mnet Financial Collection Agency, says many providers find that an additional insert with a glossary of terms, or a "What to do When You Receive a Medical Bill" brochure that outlines simple options, can be very helpful.
5. Offer alternative payment methods. A 2008 Pew Internet Study found that 39 percent of Americans pay their bills online. Providing patients with an online bill pay option can improve your patient collections. Rob Morris, vice president of marketing and new business development for CareCredit – GE Capital, says he has encountered ASCs that have accumulated hundreds of thousands of dollars in patient A/R they are unlikely to ever collect. A financing program can eliminate this A/R, increase cash flow and save money that would have been spent on staff and materials for collection efforts, he says.
In the case of CareCredit, regardless of whether the patient eventually pays, the ASC receives its payment. There are a variety of no- and low-interest payment plans. The ASC pays a processing fee on the type of payment plan chosen.
1. Always verify benefits. Don't assume prior to surgery that your patient understands how his or her insurance works, says Sandy Berreth, administrator of Brainerd Lakes Surgery Center in Baxter, Minn. Before your patient arrives at the center, call them to make sure they understand how their insurance plan works and they have the benefits they say they do.
"[Patients] just assume that their insurance is going to pay for this, and they don't understand that if they have an 80/20 insurance plan, they're going to owe 20 percent of a bill that [can total in the thousands]," she says.
2. Help patients understand the bill. Rose Eickelberger, RN, director of surgical services for two affiliated orthopedics ASCs, Summit Surgery Center and Beacon West Surgery Center, both part of Beacon Orthopedics in Cincinnati, which is operated by Practice Partners in Healthcare, says her surgery center's staff is spending more time educating patients about their bill.
"The problem is that patients don't understand their health insurance," she says. "The high deductibles are new for them." Her office calls every patient before surgery to explain the charges and provide an estimated cost, though patients are warned the amount is only an estimate. "We are working off the op notes so we don’t know exactly what procedures are involved," she says.
3. Follow up with patients who haven't paid. Whether your requirement payments to be made in one installation or you accept payment plans that let patients pay their bill in portions, you need to make sure you know the status of every patient and every payment, Ms. Berreth says. Sixty days after the third-party payor has paid their portion of the bill, you should call patients to investigate why they haven't paid.
"My collector can be like a dog with a bone," Ms. Berreth says. "She is very diligent about calling, and she has a list of people she calls on an almost daily basis." You might feel guilty for bothering people about money — especially when so many people are unable to pay their bills — but remember that you deserve to be paid for procedures, and sometimes you might be dealing with a patient who just needs to talk through their bill with an expert.
4. Include educational literature with your statements. Michael Storch, national client representative for Mnet Financial Collection Agency, says many providers find that an additional insert with a glossary of terms, or a "What to do When You Receive a Medical Bill" brochure that outlines simple options, can be very helpful.
5. Offer alternative payment methods. A 2008 Pew Internet Study found that 39 percent of Americans pay their bills online. Providing patients with an online bill pay option can improve your patient collections. Rob Morris, vice president of marketing and new business development for CareCredit – GE Capital, says he has encountered ASCs that have accumulated hundreds of thousands of dollars in patient A/R they are unlikely to ever collect. A financing program can eliminate this A/R, increase cash flow and save money that would have been spent on staff and materials for collection efforts, he says.
In the case of CareCredit, regardless of whether the patient eventually pays, the ASC receives its payment. There are a variety of no- and low-interest payment plans. The ASC pays a processing fee on the type of payment plan chosen.