The changing landscape of collections processes for hospitals
Communication between providers and patients is key
When it comes to healthcare and patient collections processes, good communication is key, said Sunni Patterson, president and CEO of RMK Holdings, a healthcare collections company in Chicago. However, she believes that for a large number of hospitals and healthcare systems across the country, communication between healthcare providers, payers and patients is the missing piece.
"It seems that some hospitals still use the traditional approach of sending out a billing statement right away to a patient. The patient often has no idea what their statement means because it's just a summary of what he or she owes and they are usually blown away by the price they see," said Patterson. "There's no communication and that's one of the missing pieces in the whole equation. Collections, in and of itself, are a very volatile and emotional thing. Coming from a hospital, it takes it makes it that much worse - it's very sensitive."
Patterson said some of the more proactive hospitals across the country, particularly nonprofit hospitals, but some for-profits as well, have implemented many changes to their billing procedure so that before patients are examined or go in for a procedure, they are educated about their payment options.
"This is beneficial for both the patient and the hospital. Some hospitals are even referring their patients to a third party for financial assistance before a procedure occurs," she said. "Giving a patient the opportunity not to go to collections really allows hospitals to receive more revenue in the end. A patient should be his or her own advocate as well. If they aren't getting the information they need, they should ask about it."
Tim Smith, senior vice president of the collections division at Firstsource, a global provider of business process outsourcing solutions in Louisville, Ky., said he believes there's been a greater emphasis in the last six months on hospitals being more mindful of the whole revenue process and verifying a patient's payment information ahead of time.
"There's been a greater emphasis on automation analytics when it comes to payments. Two years ago, hospitals in general were more manual-based," he said. "When it's more manual, there're a lot of missed opportunities with financial assistance. Hospitals have started to verify copays and insurance ahead of time and setting up payment plans at the time of the service. They've been thinking: what can we do in the revenue cycle process so that we get it right? Looking at the right patient information, financial assistance, available programs and if statements are sent on time."
Pieter Schouten, general manager of healthcare at Opera Solutions, a nationwide company that develops solutions to help hospitals increase profitability and operating efficiencies, said many hospitals can optimize the entire collections process by taking a more data-driven approach.
"A lot of our clients use multiple collections agencies and take targeted approaches that way. We are able to segment populations and customize an approach to different segments of the population. Within that, we optimize and control our placement strategy, which determines when you should go to primary or secondary collections agency," he said. "We look for duplications in the process or any overlap in eligibility companies - overlaps where you may be paying for the same service twice. The hospitals we work with are looking for improved efficiencies and better quality results."
Smith said overall he believes hospitals are becoming smarter and constantly changing processes in order to have everything run smoother.
"Hospitals have no choice but to change," he said. "They need to start embracing technology and creating smarter processes in order to compete for the limited wallet share of its customers."
