Point of service collections on the rise

As providers continue adjusting to the reimbursement changes wrought by the Affordable Care Act, it appears increasingly likely that hospitals will place more emphasis on collecting payments at the point of service.

According to the Healthcare Financial Management Association, among the 2014 applications they received from hospitals for recognition as a facility with a high performing revenue cycle operation, point of service collections were as high as 39 percent of total self-pay cash collected for individual providers, and 27 percent for very large hospital systems. Their results reflected a slight increase over 2013 results.

“Providers continue to target POS collections as a beneficial by-product of the emphasis of pre-service patient engagement and communication,” said Sandra Wolfskill, director of revenue cycle MAP at the HFMA.

According to The Advisory Board’s 2013 Survey of Hospital Revenue Cycle Operations, hospitals are indeed getting better at collecting at the point of service. The high-performance POS collections quartile improved by 64 percent since 2011, while median performance improved 38 percent.

HFMA’s Wolfskill said that the continued implementation of technology tools is critically important to boosting point of service collections. 

“Price estimator tools designed to link the patient’s benefits with the service being provided can produce the expected out-of-pocket responsibility,” she said. “They are being deployed in both the pre-service and time of service processes.”

Wolfskill explained that automated messaging systems are also being used, not only to remind scheduled patients about their upcoming service, but also as an opportunity to support the point of service collections process.

This is achieved “by reminding the patient to bring the payment that was agreed to during the pre-registration call,” she said. “Elderly patients in particular are sometimes reluctant to give credit card information over the phone.”

Nick Fabrizio, principal at the Medical Group Management Association’s Health Care Consulting Group, agreed with Wolfskill, and said hospitals and medical groups that do a better job of connecting to the patient, and outlining the patient’s responsibilities, inevitably do better in terms of collecting at the point of care.

“The better [providers] are collecting information about the patient, so when the patient comes through the door, they know what kind of insurance they have,” Fabrizio said. “If they can understand that, and verify the information, as well as communicate with the patient on the front end, then when the patient comes in the door for their first appointment, they can have a meaningful discussion about what the patient's financial obligations are.”