Revenue Cycle Management Rod Garrison

Transcription

1 Revenue Cycle Management Rod Garrison MGMA Certified Representative

2 Agenda 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

3 Today s Challenges Affordable Care Act More complicated collections Continuing reimbursement declines Staffing concerns The ICD-10 transition

4 Financial Policy Statements 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

5 Financial Policy Statements 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

6 Five Tips for Boosting Patient Collections 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

7 Collecting Patient Payment During Scheduling 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

8 Boost Collections by Cutting Down on Statements 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

9 Make Statements Effective Send statements promptly and regularly Do not put aging at the bottom of the statement

10 Statement With Aging Dates

11 Make Statements Effective Send statements promptly and regularly Do not put aging at the bottom of the statement Do put a due date on the statement

12 Statement with Due Date

13 Make Statements Effective 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

14 Establish a Credit Card on File Program 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 3 rd party Notify patients 3 times before appointment/implementation When setting appointment Send letter confirming appointment Reminder call

15 Establish a Credit Card on File Program (Cont.) 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

16 How to Talk to Patients 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?

17 Know the Warning Signs of Troubled Accounts Violated your financial policy Broken Promises Unable to reach by phone (voic , in a meeting, etc ) Missed payment, payment getting smaller Bounced check Disputed balance Affordable Care Act

18 Avoid Costly Collections Violations Be careful of messages left on answering machines Never make idle threats Make sure the 3 rd party agency is licensed in the state where your debtor is located If you receive a bankruptcy notice, your only option is bankruptcy court.

19 Facts About Collections 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

20 More Facts About Collections 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

21 What to Look for in a Collection Agency 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

22 From ARMinsider January 5, 2014 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.