Asking for the Money and Getting It

A Self-Pay Strategy

Jasmine GeeDirector, Product Marketing

1 Evaluate your current self-pay strategy

2 Explore how practice management can support your self-pay strategy

Learning Objectives

Increase in Patient Deductibles2009-2011

Deductibles are a significant percent of your contracted rate

50% of overall patient responsibility goes uncollected.

Bills Consumers are Least Likely to Pay if Lacking Funds to Pay All Bills

Source: Online Resources Corp. (ORCC), “Short on Money, Will Your Customers’ Pay Your Bill?” December 2008.

* “The ‘Retailish’ Future of Patient Collections,” Celent, February 2009

Deductible and coinsurance dollars take longer to collect…

…and are more likely to be written off!

Understanding the consumer is key to success

A 2011 survey of patients offers the following insights.

32%Don’t know

their payment

responsibility when they

leave the office.

70%Are

interested in making

payments online.

63% Would use

a payment plan if it

was made available.

* Trends in Healthcare Payments Annual Report: 2011. InstaMed.

1 Create a Self-Pay Policy

3 Make self-pay collection part of your practice workflow

2 Use technology to build efficiencies and automation into your self-pay efforts

Essential Parts of a Self-Pay Policy

Title: Announce the policy to the patient.

Consider the following:- “Financial Policy” or- “Policy on Patient Responsibility for Fees”Section 1: Describe what the policy covers.

Section 2: Describe generally that you hold patients responsible for the fees that they properly owe.

Section 3: Tell the patient when you expect payment.

Section 4: Clearly describe any late payment charges or any discount plan you may offer, making sure that you communicate all conditions and limitations recommended by your legal advisor. Section 5: Consider describing the consequences of non-payment (e.g., possible referral to a collection agency or an attorney). Section 6: Patient acknowledgement (optional).

1 Create a Self-Pay Policy

3 Make self-pay collection part of your practice workflow

2 Use technology to build efficiencies and automation into your self-pay efforts

Reminder Calls Payment

Estimator

Credit Card Processing

Text Message Reminders

Patient Portal Bill on EOB

Live Operator

What your HIT vendor should do…

• Provide scripts to help staff collect co-pays, deductibles, and previous balances

• Provide access to real time adjudication

• Enable processing of credit card, HSA/FSA card, and checks

• Enable secure storage of credit card information to pay future balances

• Enable creation of automatic credit card payment schedules

• Provide portal to accept payment, deliver summarized EOB and statement

• Provide 2 automated follow-up calls every statement cycle

• Provide 2 automated follow-up emails every statement cycle

• Provide live operator services for after-hours bill payment

• Mail up to 4 printed statements if needed

• Enable insurance card scanning

• Enable processing of payments via credit, HSA/FSA cards, and checks

• Enable secure storage of credit card information to pay future balances

• Enable creation of automatic credit card payment schedules

• Provide patient portal to communicate self-pay policy, post anticipated co-pay amounts, and take payments

• Enable swift insurance eligibility checking

Pre-visit schedulin

g Check-in Intake Exam Orders Check-out Follow-up

1 Create a Self-Pay Policy

3 Make self-pay collection part of your practice workflow

2 Use technology to build efficiencies and automation into your self-pay efforts

Make self-pay collection part of your practice workflow

It is important to work with your staff on self-pay best practices:

Help them understand the importance of collecting self-pay amounts

Provide scripts for your front desk staff to help them ask for co-pays, deductibles, and previous balances

Identify and appoint collection “aces” – these people should be in client-facing roles. And remember, asking for money is a talent. Keep this in mind when recruiting new staff

Explore incentives or recognition opportunities for self-pay staff achievements

What your practice should do…

• Use scripts to help staff request co-pays, deductibles, and previous balances

• Ask if patient wants credit card info securely stored to pay future balances

• Request payment for existing balances or establish electronic payment plan if payment can’t be made immediately

• Allocate time for billing inquiries

• Collection agency management and account selection for collection agencies

• Confirm demographics

• Collect co-pays & deductibles

• Scan insurance cards

• Collect completed HIPAA forms

• Create materials to clearly communicate policy to patients

• Consider policies for special circumstances

• Make reminder call in advance of apt

Pre-visit schedulin

g Check-in Intake Exam Orders Check-out Follow-up

• Remind patient to speak with front desk about payment

When all else fails, employ a collection agency

Once a month, review all patient balances that have aged over 120 days and send those accounts to your collection agency.

You also need to monitor your collection agency’s recovery rate and customer service skills in order to make sure that they are being both courteous and effective.

THANK YOUQuestions? Visit the athenahealth booth

for answers and a copy of the “Self-Pay Toolkit”