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POS Collectio
ns
Growing Patient Liability
Uber-Up Your Patient Payment
Liability StrategiesPatient
Advocacy
Uncompensated Care
Sponsored by
PresenterPhil C. SolomonVice President of Global Services at MiraMed
Phil serves as the Vice President of Global Services for MiraMed, a revenue cycle outsourcing company and is the publisher of Revenue Cycle News. He has over 25 years experience consulting on a broad range of healthcare initiatives for revenue cycle performance improvement by developing executable strategies for revenue enhancement, expense reduction, and clinical transformation.
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Polls & Survey
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Healthcare trends 2016
Patient payment liability facts
Why be concerned about patient liability?
Patient collection strategies
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Agenda
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Pre-visit | Post-schedule strategies
Point of service collection improvement
Patient billing statement psychology
Early stage collection improvement
Bad debt collection benchmarking
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Collection work flow best practices6
Learning Objectives
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Uber-Up Healthcare
BUse Drivers Own Cars
Smart Phone App Prices Lower Than Taxi’s
Surge Pricing
Business Model
Innovation
Cashless RideUber-Kids and Seniors
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Healthcare Trends 2016
$3.2 Trillion | Share of GDP 18%2014 Spending Grew 5.3%
U.S. Census Bureau
Courtesy of A. Lawrence Berry funds, PR1973.0467/19.
Healthcare Trends 2016Retail Healthcare
Healthcare Spending
Held HostagePhoto © dizain - Fotolia
NYC Health Business Leaders
consumerism
patient-centered caremeaningful Use
ICD-10
Acco
unta
ble
Care
Act
readmission penalty
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B2B B2C
Big Box healthcare Concierge medicine
Healthcare Trends 2016
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New Financial & Delivery System
$40 per consultation
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Patient Payment Liability
Not met deductibles
High copays or coinsurance
Lack insurance coverage
Non-covered services
Exhausted benefits
Who are they?
Patient Payment LiabilityPatient Responsibility Buckets
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True Self-pay
UnderInsured
BalanceAfter
Insurance
Polling Question
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?
Liabilities/pure self-pay patients growing 19% year
BAI growing at 30% per year
Patient Payment Liability
TPR = $700 billion McKinsey Quarterly: The Next Wave of Change for US Healthcare Payments 13
Patient Payment Liability
2104 $46 Billion
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Patient Payment Liability
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The Exchange Effect
50% higher average balances
55% higher average balance due
16% lower recovery rate
25% higher defaulted rate
10% higher final notices 2014 – 2015 HCA Study
Patient Payment Liability
National Health Expenditure Projections 2012–2022, CMS
By 2019
$200 Billion written-off
30% Annualbad debt growth
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Why Be Concerned?
McKinsey Quarterly, May 2015
3 in 4Americans Living paycheck-to-paycheck
Bureau of Labor Statistics’ 2012 Consumer Expenditure Survey
Why Be Concerned?
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>$40K = $0
To $49K = $1,508
To $69K = $3,253
Guaranteed Healthcare
…
63% can’t pay:$500 car repair
$1,000 ER visit
Patient Collections PATIENT EDUCATION
Provide A-Z guidance through the process Train patients - online tools Patient’s understanding balance due
Collection policies Confirm third party coverage Restate clinical preparation for encounter Give directions and answer questions
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Patient Collections PRE-VISIT | POST-SCHEDULE ACTIONS
Complete mini registration - On-line, mobile or phone
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Complete more developed registration
Verify payer data
Reminder call – not a collection call
Verify benefit design
Collect outstanding balances
Discuss out of pocket amount due
72-hours prior
Patient Collections POINT OF SERVICE ACTIONS
Train staff to ask, follow payment collection protocol Leverage patient obligation tools
Fee estimation – real time eligibility Predict propensity & ability to pay
Prompt-pay/self-pay discounts Payment plans with ACH - credit cards - CCOF Loans – commercial & personal Pay Cobra
Remember 501r22
Polling Question
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?
Institute for Health Care Revenue Cycle Research - A Division of Zimmerman, LLC. National Pledge to Reform Uncompensated Care Reform Underway: Adopting Best Practices to Reduce Uncompensated Care and Improve the Patient Experience. a special supplement to PATIENT PAYMENT BLUEPRINT™
Patient Collections
POS
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Patient Collections STATEMENT BEST PRACTICES
Numerous design strategies
Patients want various styles Offer an opt-out for
e-Statement discount
Use a call to action highlighting the amount to be paid
Communicate payment options (phone/email/online, etc.)25
Patient Collections e-Statements Prompt-pay discount
1st bill 20% 2nd bill 10% Last bill 5%
Incentivized to pay earlier
Compress payment cycle
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Pay Now and Save
Patient Collections EARLY STAGE BEST PRACTICES
Loan programs - recourse
Early-out outsourcing programs
Propensity | ability or pay scoring
Automated charity qualification
Score adjusted internal and external work flows
Pre-collection letter series27
Patient Collections BAD DEBT BEST PRACTICES
Analyze agency fees by net return 120 to 180 day – close inventory control Portfolio assignment split by scoring - not alpha Litigation | property liens 501r handling charity cases Secondary collection agencies Debt buying/asset selling
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Polling Question
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?
Patient Collections
3-5 statements 1-3 letters 1-2 phone calls 9-12+ months placed to
bad debt
Traditional 1 statement 1 letter to > collection 0 phone calls (various with
dialer) To early-out vendor 3-6 months placed to bad
debt Bad debt purchase
Best Practice
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6 Areas of Improvement
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Add Payment Options
Improve Early-stage Bad debt
Improve POS
Collections
Manage The
Uninsured
Update Statements
EnhanceStaff
Competency
Insurance
Exchanges
IRS501r High
Deductible Plans
THANK YOU
[email protected]: 404-849-8065
POS Collections
Bad Debt
www.miramedgs.com
