Improving Collections and Boosting Patient Satisfaction through Patient Estimation

Ric S - Headshot

By Ric Sinclair, Vice President of Product, ZirMed
Twitter: @Zirmed

At the MGMA Annual Conference in October, Cindy Welch joined me in a presentation to talk about how she overcame challenges that virtually every practice faces today—including higher co-payments, HDHPs, uninsured patients, inaccurate insurance information, staff’s reluctance to ask patients for money, and patients’ reluctance to pay.

Cindy is the practice administrator at Golden Empire Cardiology in Bakersfield, CA, which leveraged ZirMed’s solutions to reduce days in Accounts Receivable from 51 to 24, increase collections by 20%, and improve both office efficiency and patient satisfaction. They trained staff to talk with patients about their financial responsibility and set accurate expectations before providing services, introduced a patient check-in concierge service, and implemented technology to automate the patient billing process and provide an upfront estimate prior to the appointment date.

According to Cindy, changing your results starts with changing how you think about patient collections—including the where, the when, and the how. You need to train your staff to be proactive and engage with patients, beginning well before they arrive for their appointments. Key points:

  • Confirm patient information—either directly or through a patient portal—when scheduling appointments. Make sure you have all demographics, insurance information, and information from referring physicians.
  • Understand covered diagnoses for services performed. That means obtaining accurate indications for referred procedures, contacting referring physicians or patients ahead of time if provided information doesn’t support the requested service, and getting waivers when appropriate.
  • Check insurance eligibility and total financial responsibility before appointments using automated eligibility and patient estimation solutions that integrate with your PM system—then make sure patients understand what they owe up front. Contrary to what your staff may believe, communicating patients’ financial responsibility prior to the appointment actually increases their satisfaction, because they feel you’re being honest and transparent with them from the beginning.
  • Collect what patients owe—including coinsurance, deductibles, and co-pays—before they receive service. That needs to be part of your standard procedure, so review your patient check-in process and make any necessary changes. Clearly articulated policies make things simple for patients and staff alike.
  • Offer your patients convenient credit card, debit card, and online payment options to increase collections.
  • Create payment plans for patients who can’t pay the full amount up front. Use technological solutions to set up plans and withdraw payments automatically from their bank accounts or credit cards.
  • Don’t stop there. Collecting more from your patients is a process of continual improvement. Cindy’s team reviews their process regularly, looking for loopholes and challenges—and acting to correct them.

Remember—success depends on your staff. Make sure they understand what’s expected of them, include it in their job descriptions, and implement repercussions for non-collection and rewards for a job well done.

Start by teaching your staff rule number one: never ask a patient, “Would you like to pay?” Ask, “How would you like to pay?”

About the Author: Ric Sinclair is the Vice-President of product at ZirMed, a leading health information connectivity and management solutions company. In his role, Ric leads all aspects of product direction, management, design, and development.  This article was originally published on HITECH Answers.