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FEATURE Provide Education Early


ASCs should reach out to patients to discuss financial responsibility be- fore the date of service, Sackos ad- vises. “Patients have the right to be informed regarding fees for services and the ASC’s payment policies, in- cluding the estimated patient finan- cial responsibility. These discussions should take place at least three days prior to the patient’s procedure. The best approach is a simple, clear expla- nation of a patient’s estimated finan- cial responsibility. Education is key to upfront collections.”


Calling prior to the date of service Open Communication


Educating patients about their estimated financial responsibility before the date of service can help promote patient satisfaction and collections. BY ROBERT KURTZ


“With steadily increasing deductibles and higher out-of-pocket expenses, it is critical for ASCs to devote time to educating patients regarding their estimated responsibility,” says April Sackos, vice president of revenue cycle management and development for the ASC management and devel- opment company Ambulatory Surgi- cal Centers of America (ASCOA). “If patients do not understand what they owe as well as why they owe such an amount, they are less likely to cover all of their responsibilities and more likely to think negatively of their ASC experience.” With people frequently chang- ing health plans, and health plans frequently changing their plans and benefits, it is likely that many patients


do not have a strong understanding of their health care financial responsi- bilities, says Michael Orseno, revenue cycle director for ASC management and development company Regent Surgical Health. “With the confusing complexities of health care, I think patients are even more unsure about their out- of-pocket costs for their procedure,” Orseno says. “With the economy the way it is, patients are being squeezed, and what we are seeing is they are tak- ing on plans with lower premiums and higher deductibles. Since patients of- ten do not understand what this will mean financially when they have ma- jor surgery, it’s going to be the respon- sibility of ASCs to explain this to the patient.”


serves a number of purposes, Orseno says. “When we have our ASCs call their patients, the first thing they do is confirm their insurance and review it with them. Then we review their ben- efits with them. We want to make sure the patient understands how their in- surance works with our ASCs and the services we will be providing. “The second thing our ASCs do is


make patients aware of what their re- sponsibilities are going to be,” Orseno continues. “We have our staff look up their benefits, verify them and, then, based on the procedure they are hav- ing and their benefit information, we can pretty accurately determine how much they are going to owe the ASC out of pocket, and we review that with them. If the patient has that informa- tion up front, your chance of collect- ing goes up exponentially.”


Arrange Payment


It is during these calls, Orseno ad- vises, that ASCs should arrange for payment up front, whenever possible. “We attempt to arrange for the pay- ment through a credit card authori- zation form. This will work with all payers, even those with contractual language that forbids you to collect any out-of-pocket expense prior to the date of service. It works with Medi- care patients, as well.


ASC FOCUS JUNE 2013 25


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