FEATURE


and able to answer payment-related questions and help patients understand their cost share. “You must have highly skilled


workers who are mathematically competent,” she continues. “What I found helpful is to hire individuals with experience in collections. Not only are they able to discuss chal- lenging financial issues, but they have also worked with people who are unsure how they will be able to make the necessary payments.” ASCs can better set themselves up for collections success if they are pro- active in determining patient respon- sibility, Grier says. “ASD’s policy is for our ASCs to verify insurance one to two weeks prior to the date of sur- gery. This allows us an opportunity to work with patients to set up a financial agreement that works for both parties.”


Work With Your Patients With many insurance plans now car- rying deductibles of several thousand dollars, many patients will not be able to cover that expense easily, Grier says. ASCs should try to be as accommo- dating as possible so they can provide needed care to patients and still receive appropriate payment. “Accept all credit cards,” she


advises. “Also, consider using a ser- vice that provides medical lines of credit. It takes just a few minutes for a patient to get approved for a loan. The ASC receives money upfront while the lender works directly with the patient to collect the loan payment.” If a patient indicates he or she will


struggle to meet his or her financial responsibility, Martin says it is impor- tant to involve the patient’s surgeon. “The surgeon needs to understand the reasons a patient cannot meet his or her responsibilities. We work closely with the surgeon in these situations to deter- mine if the ASC is still an appropriate location for this case, and then what sort of payment plan we can develop.”


18 ASC FOCUS AUGUST 2016


As the portion of cash receipts relating to patient payments increases, ASCs must work to adapt to the changes in the health care market and insurance if they wish to remain successful.”


—Reed Martin, Surgical Management Professionals Any discussion about patient pay-


ment should happen well in advance of the procedure, Martin notes. “Too many things are happening on the day of surgery that are of a clinical nature and more important. Patient responsi- bility should not be discussed for the first time on the day of surgery.”


Cover Your Bases With so much money at stake, ASCs that want to be successful in their col- lections efforts need to follow consis- tent processes, Garrobo says. “Make sure your collections action plan and policies are hardwired. Make sure everyone at your ASC—from the beginning to end of the business side—understands that plan and those policies and keeps everything the same from patient to patient.” An ASC might want to consider making it a policy to at least collect enough money upfront to cover the costs of a case, Martin says. “That is a good yardstick for collections, which makes it important to identify the sup- ply and implant costs of a specific case well in advance of the day of surgery.” Since the cost of a case might change during the surgery, ASCs will want to address this possibility


in their financial agreement, Grier advises. “Ensure that the financial agreement states that the estimate of what the patient will owe is based off of the procedures scheduled, and make sure that the word ‘esti- mate’ is bolded on the agreement. The estimate should be verbally discussed with the patient as often- times the patient’s financial agree- ment increases on the back end due to additional procedures performed.” As the number of outstanding patient balances grows, Garrobo says her ASC focuses on collecting the highest amounts owed first. “We use a software program that helps us identify the highest dollars owed. We have our collectors go through the spreadsheet generated by the program, prioritize the high-dollar accounts and work on those first.”


It is imperative for ASCs to recognize


the evolving dynamics of collections, Martin says. “The financial lifeblood of any business will always be the cash receipts. As the portion of cash receipts relating to patient payments increases, ASCs must work to adapt to the changes in the health care market and insurance if they wish to remain successful.”


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