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Our members are from the following hospitals:
University of Washington Medical Center

St Charles Health System

Silverton Health

Skagit Regional Health

Lower Umpqua Hospital

Hawes First Financial

Southern Coos Hospital & Health Center

Mid Columbia Medical Center

Saint Alphonsus Medical Center

Cardon Outreach

Mid Columbia Medical Center

Bay Area Hospital

Skagit Regional Health

Tuality HealthCare

Sky Lakes Medical Center

Blue Mountain Hospital
United General Hospital

 

History 2010

Point of Service Collections- Discussion and Solutions

What barriers/obstacles do you face that prevent you from collecting at point of service?

OBSTACLE 1: THERE IS A NEED TO CONVINCE ACCESS SERVICES STAFF TO DOCUMENT AND COLLECT COPAYS CONSISTENTLY.

SOLUTIONS OFFERED:

1. Set & enforce expectations: Job-related functionality & compensation

  1. … Or else!
  2. Educate staff (How, Why, When)
  3. Make this part of the workflow.
  4. Scripting
  5. Copay letter as a back-up plan when unable to collect at point of service
  6. Make it part of their job description, competency, annual evaluation
  7. Tie to staff performance evals
  8. Secret shoppers to check on key points instead of exact scripting
  9. Accountability with goal or requirement for evaluation process
  1. 2. Make it part of the financial aid process
  2. Educate staff on alternative payments for uninsured.
  3. Bookmark or brochure for self-pay patient
  1. 3. Encourage competition
  2. Group recognition for being a top collector
  1. 4. Utilize Technology
  2. Reports to show what was not collected. Provide these reports to Access, clinical and executive leadership to advocate a change.
  3. Program prompting
  1. 5. Advocate from the Patient Perspective
  2. Overall patient experience doesn’t end at discharge
  3. Advocate for the patient- identifying payment options or Financial assistance
  4. Education regarding documenting the positive impact to the patient
  5. Advocate on the patient’s behalf learn their financial story and help with the potential assistance/prompt payment discounts, payment plans, etc.
  1. 6. Advocate from the Business office perspective
  2. Knowledge of billing process
  3. Education from the business office
  1. Knowledge on how the insurance company will pay
  2. The cost of not collecting it
  1. 7. Solicit Executive Leadership support
  2. Engage Top Level management support
  3. Communication plan to change the culture.

WHAT IF… What if we had unlimited funds, influence, resources to solicit change, what would we do to help convince Access Services staff to document and collect copays consistently?

  1. Discharge planners with a great discharge area to collect copays
  2. Concierge for each patient- from pre-reg to registration to discharge
  3. Discharge area- unable to leave until they pay
  4. Insurance cards will have copays and deductibles
  5. Remodel building to have only one way out with a discharge desk and financial counselor with lots of staff
  6. A price estimator for all ED patients
  7. Get a % of the amount collected

OBSTACLE 2: THERE IS A NEED TO CONVINCE CLINICAL STAFF TO COPERATE WITH ACCESS SERVICES STAFF ON POINT OF SERVICE COLLECTIONS.

SOLUTIONS OFFERRED:

1. Advocate on the patient’s behalf.

  1. This is part of patient care as well.
  2. Encourage clinical staff we are advocating for the patient
  3. Explain the reasons for point of service from the patient perspective learn their financial story to advocate for the patient

2. Advocate from a monetary perspective.

  1. Employees might not get paid themselves if no money to collect

3. Advocate team ownership of issue

  1. Education of clinical staff for reasons we need to collect
  2. We are all on the same team
  3. Involve staff who will be collecting as well as the clinical staff
  4. Develop collaborative relationships with clinical and access services staff
  5. Develop activities so they can experience our challenges (walk in my shoes)

4. Engage executive and/or clinical leadership support

  1. Make it part of the clinical staff job description (and hold them accountable)
  2. Employee forums- everyone involved, including executive teams.

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Copyright © 2005, Greater Northwest Healthcare Access Management Association, All rights reserved.
Updated September 22, 2012