ED collections doubled with these changes
Change the 'bill me later' approach
What's the toughest challenge if you want to get serious about emergency department point-of-service (POS) collections? "Changing behavior with the staff as well as the patients," says Denise Helm, director of patient access at St. Rose Dominican Hospital in Las Vegas. "Both prefer the 'bill me later' approach."
Once a patient leaves, the likelihood of collecting decreases. Another challenge is that due to the emergent nature, sometimes patients do not come prepared to pay.
To improve ED collections, all patient access staff at St. Rose Dominican were trained on POS collections. This includes scripting for a variety of different responses.
In addition, a POS collection grid was created for self-pay patients, as well as a copay cheat sheet. For those patients not prepared to pay, the registrar will present them with a letter and a self-addressed stamped envelope and ask that they remit their payment as soon as possible.
"We also utilize friendly competition between employees and the three St. Rose facilities to encourage increased collections," says Helm. "Our ED POS collections for March and April 2009 have increased an average of 200% across all three facilities, when compared to the same time period in 2008."
"In 2007, we restructured our front-end model in the emergency department," says Jodie Martin, director of admitting and registration for the department of revenue management at University of Kentucky Healthcare. "The registration staff who were currently reporting to ED nursing were moved to revenue management and began reporting to me. Our goal was to emphasize the business requirements of the position."
To that end, clerical tasks were pulled out of the list of registration staff duties, and clerical-level positions were developed to assume the non-registration tasks.
"At the same time, we also developed scripting and provided enhanced training programs for registration employees. Copay and self-pay collections were emphasized," says Martin.
Collection requirements were added to performance appraisals standards, and regular meetings regarding the topic were held. Periodic reports were developed and sent to staff by the ED registration manager, and monthly reports of the results of collection efforts were presented at high-level revenue cycle meetings.
"The results were impressive," says Martin. "Almost immediately, we saw a monthly doubling of collections. Some months, collections actually tripled, yielding a cumulative total for 2007 that was double that for 2006."
Since 2007, collection rates have remained fairly stable. "With the recent challenges of this new economy, we are beginning to struggle with maintaining that stability, much less surpass it," says Martin. "However, our plan is to dust off the strategies that worked so well in 2007 and reintroduce them."
What's the toughest challenge if you want to get serious about emergency department point-of-service (POS) collections? "Changing behavior with the staff as well as the patients," says Denise Helm, director of patient access at St. Rose Dominican Hospital in Las Vegas. "Both prefer the 'bill me later' approach."You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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