Revenue Cycle Management Rod Garrison

Revenue Cycle

Management

Rod Garrison

• Challenges medical practices are facing • How to communicate with your patients • Effectively collecting patient payments

• Eliminating your practice’s aging accounts receivable • Understanding your options for collecting your money

• Affordable Care Act

• More complicated collections

• Continuing reimbursement declines • Staffing concerns

• The ICD-10 transition

• Have a defined credit policy

 Detailed  One policy

• Some things to include:

 Allowable forms of payment

 Policy on insurance assignments  Self-pay policy

 At time of service vs. payment plans?  How many payments?

 How many statements?

 Charity programs

 How does one qualify?

 Write-off policies  Collection policies

 When to turn one over  Balance driven

• Some things to include: (continued) • Allowable forms of payment

 Other fees

 Broken appointment  Form completed  Copies

 Returned check

 Interest or collection fee (be specific)  Co-pay billing fee

 Authorization to release information

Make sure the forms are signed

• Make the most of your collection opportunities

 When a patient calls  When they arrive  At check-out

• Be clear with patients

 Financial Policy

 Financial Consultant

 Nonemergency procedures  Long treatment protocol

 Should be someone from billing specifically trained for this role • Train your staff correctly

 Front desk staff should have a script to follow

• Accept all forms of payment

• Establish a good follow-up plan

 Statements  Phone calls  Letters

 Third-party

• Scheduling is the first contact … and most important • Minimum information to be obtained:

 Demographics – Name, address, cell number, work number, SSAN, DOB

 Insurance information – ID number, group number, payer ID, guarantor information  Reason for visit

 “Are there records or test results needed before being seen?”

• Scheduler should request payment of any balance

“Ms. Smith I see you have a past due amount of $50. How would you like to take care of that today? We accept Visa, MasterCard, or do you have an HSA card?”

• No longer an option … but a must

• Gather at least three days before visit

• Front-office staff

 Didn’t collect co-pay, coinsurance or deductible  Didn’t collect according to plan details

• Improper posting

 Institute checks and balances at the end of each day

• “Oops, I forgot my checkbook/credit card”

 Call it in by the end of the day or you will incur a late charge tomorrow

(if the patient can’t pay now, they won’t at the end of the month when they get a statement)

• Staff adjusts off a patient deductible

• Stop sending statement after statement … it’s a poor way of running a business

• Send statements promptly and regularly

• Do not put aging at the bottom of the statement

• Send statements promptly and regularly

• Do not put aging at the bottom of the statement • Do put a due date on the statement

• Send statements promptly and regularly

• Do not put aging at the bottom of the statement • Do put a due date on the statement

• Do not state “Amount Enclosed” with a blank box • Offer online payment option

• Offer credit card option for payment • Use ‘Address Service Requested’

• Why?

 Significantly increases your practices cash flow  Significantly decreases your accounts receivable

 Reduces your patient collection expense immediately

• Payment Gateway Company

 Web access for securely storing a credit card  Credit, debit and sometimes HSA card

• “But isn’t it expensive?”

 MGMA -> $7 per statement if not done electronically

 Eliminates statements & deposits and need for a 3rd _party

• Notify patients 3 times before appointment/implementation

 When setting appointment

 Send letter confirming appointment  Reminder call

• Medicaid/Medicare

 Medicaid – co-pays are small, not necessary

 Medicare – Yes, but don’t collect at time of service if they have a secondary or supplemental insurance plan

•Affordable Care Act – because of the high deductible plans, definitely necessary

• What you should not say:  “How much can you pay?”

 “When can you pay?”

 “Can you pay something today?” • What you should say:

 “How much are you short?”

 “What time should I be expecting you today?”

 “Will you be paying by cash, check or credit card today?”

• Violated your financial policy • Broken Promises

• Unable to reach by phone (voicemail, in a meeting, etc…) • Missed payment, payment getting smaller

• Bounced check • Disputed balance • Affordable Care Act

• Be careful of messages left on answering machines • Never make “idle threats”

• Make sure the 3rd _{party agency is licensed in the state where} your debtor is located

• If you receive a bankruptcy notice, your only option is bankruptcy court.

• There are approximately 4500 collection agencies in the U.S. • The Fair Debt Collection Practices Act (FDCPA) is designed

to protect consumers

• The Telephone Consumer Protection Act (TPCA) restricts the use of automated telephone equipment unless specifically

authorized and signed off on by the debtor

• If you receive a bankruptcy notice, your only option is bankruptcy court

• Average fee/cost for a traditional agency is 30%*

• Average recovery rate for non-hospital medical collections is 10.8%*

* ACA International Survey

• 80% of the amount collected by a third-party is from the fourth contact

• Working an account via phone has a 10% chance that the call will get through to the patient

• Most malpractice suits are with patients who owe money

• Licensed, bonded, insured • All terms in writing

• References available • Reputable

• Experienced in your industry • Hold harmless agreement

• Size of the agency

• Nationwide coverage • Pricing

• Transparency

• Easy to do business with

• Partners with key professional associations • Soft or hard collections at your direction

From ARMinsider

Court Says No to Percentage-Based Collection Fees

In the first legal setback of the year for the ARM industry, an appeals court Thursday reversed a lower court ruling and found that a collection agency violated the FDCPA when it charged a consumer a collection fee that was based on a percentage of the debt balance rather than actual costs. The good news here is that with proper consumer agreement language, violations can be avoided

while charging percentage fees. The bad news is that the responsibility falls on the creditor/client.