FEATURE Best Practices to Secure Patient Payments
Make your collections efforts successful BY ROBERT KURTZ
C
ollection from patients will become more challenging as the insurance plans change, says Melodie Garrobo, CASC, administrator for Golden Ridge Surgery Center in Golden, Colorado. “The patient population became accustomed to coming into a facility, receiving care and worrying about pay- ment later,” she says. “This used to be acceptable with most health care insti- tutions but that was when insurance covered most of the payment. Con- sumers are moving to high-deductible insurance plans, which means less of the payment comes from insurance and more must come from patients. This is a new world, and ASCs must make patient collections a priority.” That will likely be easier said than
done, says Baton Rouge, Louisiana- based Kelly Grier, senior vice presi- dent of business operations for ASC
management and development com- pany ASD Management.
“Collecting estimated patient co- insurance and deductibles upfront reduces the effort to chase the money after insurance pays, but a facility is often faced with having to share this effort with all of the providers— e.g., surgeon, anesthesia provider— associated with the case,” she says. “This decreases the patient’s avail- able money to cover all providers’ charges.” A lack of understanding about new insurance plans is also creating challenges, Garrobo says. “Many of the patients we have seen in the past few years have never had a high-deductible plan and do not know what this means. Even our most educated patient population does not understand payment rules, which makes it more difficult to try to collect larger sums of money.”
ASCs in some markets might face a dilemma about when to collect money from patients, says Reed Martin, chief operating officer for Surgical Man- agement Professionals, a Sioux Falls, South Dakota-based ASC and surgical hospital management, consulting and development company. “Not all ASCs or hospitals do upfront collections,” he says. “It could be seen as a competitive disadvan- tage if your facility is attempting to do so. On the other hand, it can also be construed as a patient satisfier. Many patients appreciate the fact that they can know before their service what their financial responsibility will be.” ASCs that wish to overcome these challenges must be proactive in their efforts, Martin says. “It is more and more important, and will probably continue to be more important in the future, to set up very good systems for accounts receivable collections relating to patient payments.”
Focus on Education If ASCs want to improve collections, they must allocate time and resources to patient education, Martin says. “It is important for patients to under- stand their responsibility before they arrive for their procedure,” he says. “There are now tools available from many of the large payers that identify patient deductibles, how much of that deductible has been met and any coin- surance for procedures. When you com- bine that information with procedure estimators—i.e., what procedures will be included in the case and the allowable amount by payer for those procedures— it will help you calculate the patient’s overall financial responsibility.” Garrobo is hiring staff members
who are equipped to discuss financial responsibility with patients. “You can- not just hire receptionists anymore. The individual at your front desk needs to be well-versed in what the financial impact is going to be on the patient
ASC FOCUS AUGUST 2016 17
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