The increasing popularity of High-Deductible Health Plans have sent the portion of a healthcare bill that is the responsibility of the patient skyrocketing in recent years. That increased burden on patients is also an increased burden on healthcare providers, who need to do a better job of collecting unpaid debts earlier in the process, before it becomes bad debt. Does anyone expect healthcare costs to decrease anytime soon? That only makes it more important for providers to build processes that help them collect as much as possible, as soon as possible.
Too many providers are still caught in the cycle of sending the same letters month after month and hoping that a patient is going to one day respond to a letter and decide to make a payment. Providers forget that the older receivables become the harder they are to collect. Many providers have not come to the realization that they need to make changes to their collection processes — such as communicating with patients at times and through channels that are convenient to them.
Making small changes to how receivables are collected can pay huge dividends down the line. Here are some other small changes that providers may want to consider.
BE AWARE OF WHAT YOU CAN AND CAN’T DO
Taking some initiative and joining trade groups and associations can help a provider stay updated about important trends and developments. Associations like ACA International or the Healthcare Financial Management Association offer great educational resources as well as networking opportunities. Learning what you can and can’t do may also mean getting up to speed on the federal, state, and local laws and regulations regarding debt collection. State debt collection laws like the Florida Consumer Collection Practices Act, or FCCPA, mirror federal laws on debt collection. Staying updated also means learning about the recently released debt collection rule from the Consumer Financial Protection Bureau.
Many times the information needed to successfully collect a debt is simply not verified or checked, leaving a provider without an updated addresses or phone number. Providers should also be asking for work and personal email addresses from patients. If you are a provider following up for a patient who received initial care somewhere else, ensure there is a process in place to get updated information from that provider in case the patient contacts them later but not you. Providers should also ask for the copay upfront, whenever possible. Staff need to be trained not to avoid having discussions about money because they can be awkward. Whenever possible, make the payment method as convenient for the patient as possible, whether accepting cash, credit card, ACH, HSA, or a payment app like Venmo or Zelle. It is uncomfortable to ask for money for many people especially in a medical situation, but one would not expect to go to a restaurant and eat a meal without paying. Providers and hospitals deserve to get paid and many times people DO have the ability to pay or enter into a payment arrangement but they are simply not asked. If, for whatever reason, payment is not obtained, correct data is critical for collection after the fact. This is especially important since a person may qualify for charity care if there is a policy in place for it like for the tax-exempt hospitals under IRS 501R guidelines. Technology is a great tool to help verify addresses, screen for propensity to pay, and verify insurance and eligibility so that you will know expected out-of-pocket liability. Extended payment plans and arrangements, whether in-house or through a vendor, should be considerations to reducing bad debt. Ensure you have a solid guarantor agreement with language to cover ultimate patient responsibility for any amount not paid for services rendered. The agreement should have provisions for providers and any subcontractors to communicate to the patient/guarantor’s cell phone using an automatic telephone dialing system (ATDS), SMS, or to send an email for treatment, payment, operations, or follow up needed at or after the time of service. Also, be aware that under the Telephone Consumer Practices Act (TCPA) a consumer has the right to revoke that consent in a manner convenient to them. If revocation of consent occurs on the front end, but the account is already with a collection agency or another vendor, ensure that you have a process in place to let them know about the revocation. Similar protocols should exist to notify that an attorney now represents the patient, they are filing bankruptcy, or you receive deceased/probate information.
LET IT GO!
If you have done all you can with your current resources and technology, engage a good collections agency to partner with. Whether you engage one in an “Early Out” or pre-collect environment as an extension of your own business office, third party bad debt or both, engage them. Don’t sit on receivables for a long time hoping and praying the patient will eventually pay. The older a debt gets the harder it is to collect. A good agency won’t just sit in the background and send you some money every month. A good agency will make recommendations based on their experience and what they are finding with YOUR accounts and data. They will recommend special campaigns like tax season discounts to encourage settlements, or salvage campaigns on older receivables to get you paid. They will keep you informed of changes with regard to compliance and expectations like changes with the TCPA or CFPB. Develop a strategy that you are comfortable with and hold them accountable. Ask them what technology they are using to ensure their calls are getting through and not being blocked by apps and services. Are they calling or are they just sending letters? After all, if the patient didn’t respond to the provider’s dunning notices, what makes you think they are going to respond to the agency’s? Do they use dialer, ringless voicedrop, and SMS technology to collect on your debts and make it convenient for patients that sincerely want to pay their bills? How are they staying compliant with changes in laws and regulations? How involved are they with the accounts receivable management (ARM) industry?
Asking questions and staying informed will ensure the agency gives your extended receivables the attention they deserve with the highest possible recoveries and doing so with minimal complaints. Compliance and compassion in the revenue cycle process should reduce exposure to liability for the provider as well as the agency for accounts in collections.