Transcript Point-of-Service Collections: Improve Cash Flow Through

Automating Estimation of
Patient Services
Jonathan G. Wiik, MSHA, MBA
Imaging Operations Manager
Boulder Community Hospital
Val Kraus, MBA
Director of Admissions & Case Management
Boulder Community Hospital
1
Estimation of Patient Services
– Introduction
The overall cost to collect is typically reported between 2
and 3 percent…
Front-end processes are important … especially in this
era of increasingly high co-payments and consumerdirected health plans.
…. the more time that passes following the patient’s
discharge, the cost to collect on that account continues
to go up while the chance of actually collecting payment
goes down.
Therefore, any payment that can be collected early in the
patient encounter is more valuable in the long term.
2
Estimation of Patient Services
– Introduction
Why Should the Patients Pay in Advance?
Patients need to be educated and understands their
financial obligations for the care they are receiving
Eliminate discharge delays
 Eliminate worry about how to cover patient-pay portion
 Maintain or establish good credit record
 Patients earn piece of mind knowing their obligations
have been met
 Avoid future collection headaches
The Advisory Board Company – HWORKS initiative
3
Estimation of Patient Services –
Current Trends
"The immediate goal is to make sure there are
more people on private insurance plans.
I mean, people have access to health care in
America…..after all, you just go to an emergency
room.”
- President George W. Bush
AFP PHOTO/Saul LOEB
4
Estimation of Patient Services –
Objectives
Session Objectives:
1. Discussion of trends in current Health Care
market
2. Identify best practices to maximize collection
efforts
3. Understand components of Estimating PreService
4. Streamline scheduling and reception workflows
5. Outline training for front-line staff
5
Estimation of Patient Services
6
Current Trends
Estimation of Patient Services –
Current Trends
The problem of the uninsured is continuing to grow. The federal government
estimates that nearly 45 million individuals lacked health insurance coverage
of any kind during 2005. Other research shows that tens of millions more
Americans go without health coverage for shorter periods of time.
Percentage of Non-elderly Adult Workers Without Health Insurance, 1987-2005
Source: Employee Benefit Research Institute estimates from the Current Population Survey,
March 1988-2006 Supplements
7
.
Estimation of Patient Services –
Current Trends
Uninsured
16%
47.4 Million Uninsured!
EmployerSponsored
Insurance
53%
Medicaid/
Other Public
12%
Medicare
14%
2006 Total = 296.1 million
Private NonGroup
5%
NOTE: Includes those over age 65. Medicaid/Other Public includes Medicaid, SCHIP, other state programs, and military-related coverage. Those enrolled in both
Medicare and Medicaid (1.8% of total population) are shown as Medicare beneficiaries.
SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of March 2007 CPS.
8
Estimation of Patient Services
– Current Trends
$4.3T
$4,500
$4,000
$3,500
Dollars in Billions
$3,000
$2,500
2,105.5
2,555.1
2,905.1
3,305.0
3,757.0
$2,000
$1,500
$1,000
$500
$0
2006*
NHE as a % of GDP:
2,245.6
2,394.3
2,725.8
3,097.8
3,523.6
4,277.1
4,007.8
16.0
16.3
2007
16.6
2008
2009
16.9
2010
17.1
2011
17.4
2012
17.7
2013
18.0
2014
2015
18.4
2016
18.8
2017
19.1
19.5
*2006 are actual data from the 2006 National Health Expenditure Accounts; 2007-2017 are projected data from the 2006 National Health Expenditure Accounts.
Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, at
http://www.cms.hhs.gov/NationalHealthExpendData/03_NationalHealthAccountsProjected.asp#TopOfPage (see Projected; NHE Historical and projections, 1965-2017, file nhe6517.zip) and http://www.cms.hhs.gov/NationalHealthExpendData/ (see Historical; NHE summary including share of GDP, CY 1960-2006; file nhegdp06.zip).
9
Estimation of Patient Services
– Current Trends
What are a BILLION or TRILLION
Dollars?!!
$
1,000,000,000,000……”12” zeros…..or….. “one-thousand-billion”:
– One Million dollars stacks up 500 feet - as tall as the big pyramid in Egypt
– One Billion dollars is 10 times higher than Mt. Everest
– One Trillion dollars is 1/4 of the way to the Moon or 60,000 miles.
– It would take someone more than 30 years to “count aloud” to one Billion
– If you had gone into business on the day Jesus was born [~2013+ years ago],
and your business lost a million dollars a day, day in and day out, 365 days a
year, it would have taken you until October 2737 to lose just ONE Trillion dollars
www.buelahman.wordpress.com/2008/05/06/what-does-a-trillion-look-like
www.jimloy.com/math/trillion.htm
www.scoroncocolo.com/debt.html
www.ehd.org/science_technology_largenumbers.php
10
Estimation of Patient Services
– Current Trends
Percent who say each of the following happened to them/their family
member as a result of the financial cost of dealing with cancer…
46%
Used up all or most of
savings
22%
30%
Borrowed money from relatives
10%
Unable to pay for basic necessities
like food, heat, or housing
Declared bankruptcy
41%
7%
6%
3%
Ever uninsured
Always insured
Source: USA Today/Kaiser Family Foundation/Harvard School of Public Health National Survey of Households Affected by Cancer (conducted Aug 1-Sept 14, 2006)
11
Estimation of Patient Services
– Current Trends
Financial Burden of Medical Bills by
Insurance Status, 2005
Percent of adults (age 19-64) reporting in past 12 months
Medical Bills
Had a Major
Financial
Impact
29%
14%
Insured
Spent Less on
Basic Needs to
Pay for Health
Care
Contacted by
Collection
Agency about
Medical Bills
Uninsured
34%
12%
18%
9%
NOTE: Insured includes those with public or private insurance coverage.
SOURCE: Kaiser Commission on Medicaid and the Uninsured analysis of the Kaiser Low-Income Coverage and Access Survey 2005:
National All-Income Sample.
12
Estimation of Patient Services
– Current Trends
% OF US DOLLAR SPENT BY CONSUMER 2008
TRANSPORTATION
4%
CAR FUEL
4%
CLOTHING
4%
RECREATION
4%
MEDICAL
CARE*
17%
HOUSEHOLD/FURNITURE
4%
CAR
4%
RENT/MORTGAGE
16%
FOOD
14%
•Medical care includes all expenses, including premiums,
prescriptions, and out-of-pocket costs
OTHER**
14%
UTILITY BILLS
15%
** Other includes food other than groceries, alcohol, tobacco,
luxury items, etc.
Bureau of Economic Analyis - Personal Consumption Expenditures by Major Type of Product and Expenditure
www.bea.gov/national/nipaweb/nipa_underlying/TableView.asp?SelectedTable=19&FirstYear=2007&LastYear=2008&Freq=Qtr
13
Estimation of Patient Services
– Current Trends
14
Estimation of Patient Services
– Current Trends
Average annual premium for family of four in
20081?….
$3,300
Average out-of-pocket costs for family of
four (incl. Premium above)2?….
$6,075
Average annual health care costs for family
of four2?….
$16,000
1.
National Coalition on Health Care 2008.
www.nchc.org/facts/cost.shtml
2.
Medical News Today (Coverted to 2008 using 10% inflation rate)
www.medicalnewstoday.com/articles
15
Estimation of Patient Services –
Current Trends
Having a job, even a full-time job, does not
guarantee access to health insurance.
Uninsured Non-elderly Population by Work Status of Family Head, 2005
Source: Employee Benefit Research Institute estimates from the March Current Population
Survey, 2006 Supplement
16
Estimation of Patient Services –
Current Trends
Many workers are paying higher co-payments for physician visits in HMOs.
Percentage of Covered Workers Facing Various HMO Co-payment Amounts for Physician
Office Visits, 1996-2006
Source: Kaiser Family Foundation/Health Research and Educational Trust.
17
Estimation of Patient Services –
Current Trends
Distribution of Deductibles for Employee-Only PPO Coverage, 2000-2006
Source: Kaiser Family Foundation/Health Research and Educational Trust.
18
POS COLLECTIONS
– Current Trends
Distribution of Health Plan Enrollment for Covered Workers, by Plan
Type, 1988-2007
1988
73%
1993
16%
46%
1996
27%
1999
10%
2000*
8%
2001*
2002*
31%
4%
24%
2004
5%
25%
3%
3%
20%
2007
3%
21%
0%
23%
52%
18%
54%
17%
55%
21%
2006
21%
46%
27%
5%
24%
42%
24%
7%
14%
39%
29%
7%
26%
28%
28%
2003
2005*
21%
11%
15%
61%
15%
60%
13%
57%
20%
40%
13%
60%
* Distribution is statistically different from the previous year shown (p<.05). No statistical tests were conducted for years prior to 1999.
No statistical tests are conducted between 2005 and 2006 due to the addition of HDHP/SO as a new plan type in 2006.
Note: Information was not obtained for POS plans in 1988. A portion of the change in plan type enrollment for 2005 is likely attributable
to incorporating more recent Census Bureau estimates of the number of state and local government workers and removing federal
workers from the weights. See the Survey Design and Methods Section from the 2005 Kaiser/HRET Survey of Employer-Sponsored
Health Benefits for additional information.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2007; KPMG Survey of Employer-Sponsored Health Benefits,
1993, 1996; The Health Insurance Association of America (HIAA), 1988.
4%
5%
80%
100%
Conventional
HMO
PPO
POS
HDHP/SO
19
Estimation of Patient Services
20
Industry Best Practices
Estimation of Patient Services
– Best Practices
OUR JOURNEY…
BCH POS COLLECTIONS TIMELINE
3/28/05: BDY SITE POS
COLLECTIONS GO LIVE (PILOT)
8/22/05: FTH SITE POS
COLLECTIONS GO LIVE
Jan-05
Jun-05
9/1/07: CCI ACTIVE ALL IMAGING
SITES
4/1/06: BCH POS COLLECTIONS
INTIATIVE
(CICP/WECARE/HWORKS)
Dec-05
8/29/05: BMC SITE POS
COLLECTIONS GO LIVE
8/15/05: CMC SITE POS
COLLECTIONS GO LIVE
1/1/08: BCH SITE PILOTS
ESTIMATOR
8/28/06: CCI PAY GO LIVE BDY
SITE (PILOT)
Jun-06
Dec-06
1/27/09 PRESENTED RESULTS AT
HFMA SYMPOSIUM
Jun-07
1/25/07: POS COLLECTIONS TASK
FORCE INCEPTION
Dec-07
Jun-08
4/1/2008: ELGIBILITY AND
BENEFITS FOR SCHEDULED
PATIENTS
11/1/07: DEDICATED INSURANCE
SPECIALIST HIRED
21
Estimation of Patient Services
– Best Practices
IMAGING SELF PAY PRICING TABLE
DEPT
CT
CT
CT
CT
CT
CT
CATEGORY
ANGIO / RUNOFF
NON ANGIO
ABDOMEN SCREENING**
CT VIRTUAL COLONOSCOPY**
CARDIAC SCAN CALCIUM SCORE**
LUNG SCREENING**
** Discount does not apply with these exams
DEPT
CATEGORY
DX SPINAL PROCEDURE (I.E. MYELO)
DX ARTHROGRAM
DX FLUORO (GI/GU)
DX LUMBAR PUNCTURE
DX DEXA
DX PLAIN FILMS (ALL OTHER)
DX PLAIN FILMS (< 3 VIEWS)
NOTE: This Pricing Table is for quoting/collecting amounts on
SELF PAY PATIENTS ONLY, w ho pay at the time of service
(REV 3/20/06)
SELF PAY DISCOUNT PRICE
$1,900.00
$900.00
$965.00
$695.00
$490.00
$390.00
SELF PAY DISCOUNT PRICE
$1,100.00
$600.00
$500.00
$300.00
$200.00
$200.00
$75.00
** < 3 VIEWS M NEUM ONIC EXAM PLES INCL: " KNEE" , " FINGER" , " SCAPULA" ," CLAVICLE" ," ELBOW" ," PELVIS" ," KUB" ," SACCOC" ," HUM ERUS" ," HAND" ,
ETC.
DEPT
MA
MA
MA
MA
MA
CATEGORY
STEREO BX (Deposit Platform*)
NEEDLE LOC / GALACTOGRAM
DX MAMMO (BILAT, incl CAD)
SCREEN MAMMO (BILAT, incl CAD)
DX MAMMO (UNILAT, incl CAD)
$
$
$
$
$
SELF PAY DISCOUNT PRICE
2,000.00
800.00
160.00
130.00
100.00
DEPT
MR
MR
MR
MR
CATEGORY
BREAST MR LOC / BX
W & W/O CONTRAST
BREAST MR
W or W/O CONTRAST
$
$
$
$
SELF PAY DISCOUNT PRICE
2,500.00
2,400.00
1,700.00
1,100.00
DEPT
CATEGORY
US PROCEDURE (INCL DRAIN, BX, VEIN MAPS, ETC)
US OB, BREAST SONO, OTHER
US LIMITED OR F/U, GEN COUNSELING
$
$
$
SELF PAY DISCOUNT PRICE
700.00
400.00
200.00
DEPT
CATEGORY
IS ALL (DEPOSIT PLATFORM)*
$
SELF PAY DISCOUNT PRICE
750.00
DEPT
CATEGORY
NM ALL (DEPOSIT PLATFORM)*
PET ALL (DEPOSIT PLATFORM)*
$
$
SELF PAY DISCOUNT PRICE
1,000.00
2,500.00
* Deposit Platform is a partial payment (deposit), patient will be billled for the remainder at a 40% discount.
OVERALL ESTIMATE (USE ONLY IF ABOVE NOT DETERMINED)
DEPT
AVG PRICE
CT
$
1,422.14 $
DX
$
358.33 $
IS
$
1,216.98 $
MA
$
485.26 $
MR
$
2,217.66 $
NM
$
1,658.62 $
PET $
3,504.00 $
US
$
540.02 $
OVERALL ESTIMATE
750.00
150.00
750.00
150.00
1,250.00
1,000.00
2,500.00
250.00
22
Estimation of Patient Services
– Best Practices
CURRENTLY:
~25% Collection Rate
or 1.2% of Gross A/R
BOULDER COMMUNITY HOSPTITAL
POS COLLECTIONS
2004 TO CURRENT
$7,000,000
45000
42474
$5.8M
$6,000,000
35757
$4,000,000
35000
28735
30000
22342
25000
$3.3M
18747
$3,000,000
$2.9M
20000
$2.3M
15000
$2.0M
$2,000,000
$1.4M
$1.1M
$1.2M
10000
$1,000,000
5000
$-
0
2004
2005
2005 CCI$
2006
2006 CCI$
2007
2007 CCI$
2008*
2008 CCI$*
PERIOD
AMOUNT
COUNT
23
COUNT
AMOUNT
$5,000,000
$5.2M
40000
Estimation of Patient Services
– Best Practices
DO THE MATH!:
Annual self pay losses versus savings in upfront collection:
Would you like to lose “$3.5M” OR
“$2.0M”
this year ???
- Point of Service Collections, Techniques that Work, HFMA, Sandra Wolfskill
24
Estimation of Patient Services
– Best Practices
Have clear intentions…
 Patients First, Collections Second1
 Treat ALL patients equitably, with dignity, with respect,
and with compassion2
 Serve the Urgent and Emergent needs of everyone,
regardless of their ability to pay2
 Assist patients who cannot pay for their part of the
care they receive2
 Provide resources, NOT restrictions
 Make it an EXPECTATION
1. Point of Service Collections, Techniques that Work, HFMA, Sandra Wolfskill
2. Patient Friendly Billing Project, February 2005 Report
25
Estimation of Patient Services
- Best Practices
Best Practices of Top-Performing Facilities:
– Adopt guiding principles and communicate the
message
– Set the expectations, and establish
accountability
– Update the mission, job descriptions, policies,
and procedures
– Couple patients with the best funding
mechanism available
– “best” could be charity care
Overwhelming The Bad Debt Crisis - HWORKS
Patient Friendly Billing Project, February 2005 Report
26
Estimation of Patient Services
– Best Practices
Identify and address the “barriers”:
We do not know what to collect?!
I’m not asking people for money?!
This is against our policy?!
You have never collected this from me before?!
Public Relations and Communications
Insignificant Dollars
- Point of Service Collections, Techniques that Work, HFMA, Sandra Wolfskill
27
Estimation of Patient Services
Components and Tools
28
Estimation of Patient Services
– Components and Tools
Components of a Successful POS Collection
Program:
1.
2.
3.
4.
5.
Metrics (Data)
Executive-Level Support
Active Participation at All Levels
Policy, Procedure, Protocol and Scope
Patient Education
29
Estimation of Patient Services
– Components and Tools
1. Metrics - DATA
High Level
–
–
–
–
Billed Revenue
Reimbursement
Up-front (POS) Collections (if any)
Bad Debt Write-offs ($)
Detail
–
–
–
–
–
–
Payer Mix including Self-Pay (uninsured)
Account Aging and Costs (A/R, Collections agency, etc.)
Patient Mix (Outpatient, Inpatient, ED)
Number of Scheduled Patients and Walk-ins
Modality Mix (CT, MRI, XRAY, ULTRASOUND)
Access Points and Volume at each area
(Scheduling/Reception/Intake/Admissions)
30
Estimation of Patient Services
- Components and Tools
Why so much data?!
•
•
•
•
•
Get a Baseline (What can we track?)
Identify Priorities (Why is this important?)
Focus efforts (Who will be impacted?)
Establish Goals (When can we do this?)
Determine Needs (How can we do this?)
31
Estimation of Patient Services
– Components and Tools
KNOW your numbers….
•
•
•
•
•
How much should an uninsured person pay?
What do we collect if it is not on the card?
What do we do if data is not available?
How do (or can) we estimate allowable?
What can we (or can we not) estimate in advance?
32
Estimation of Patient Services –
Drill down to the
core….
Components
and Tools
33
Estimation of Patient Services
– Components and Tools
2. Executive-Level Support
• Bottom-up, top-down, sideways, and up-side-down,
the organizational CULTURE must live, breathe,
and act consistently
• Every person, from the Radiologist to the
Receptionist, from the Office Manger to the patient,
must clearly understand the project and its rationale
• Services should not be reduced in a POS
Collections Program – they should be ENHANCED
34
Estimation of Patient Services
– Components and Tools
2. Executive-Level Support (cont.)
Typical POS Collections Team:
•
•
•
•
•
Executive - VP/CFO, Owner, Office Manager
Director / Site Manager (s)
Billing and Contracting
Admissions / Scheduling / Reception
Others?
– If multi-site/functional areas, leads from each access
point should be represented
– Should end up with 6-8 “key” personnel involved in
patient and billing flow
* This group should have a philosophical, business-decision discussion
concerning “boundaries” PRIOR to any implementation
35
Estimation of Patient Services
– Components and Tools
3. Active Participation at All Levels
Administration and Management
Billing
Financial Counselors
Clinical Personnel
Other Areas
36
Estimation of Patient Services
- Components and Tools
Letters/Communication do not hurt…..
37
Estimation of Patient Services
– Components and Tools
3. Policy, Procedure, Protocol and Scope
“Three Doors” for funding their care:
Insurance
No Insurance (self-pay)
Other Funding Mechanism (be
specific)
ONE (AND ONLY ONE) OF THE ABOVE MUST
BE ELECTED BY THE PATIENT PRIOR TO
RENDERING SERVICES – NO EXCEPTIONS!!!
38
Estimation of Patient Services
– Components and Tools
• “DOOR” will determine direction and
conversation we take with the patient:
– “Collection Advisory” List
• Medicare/Medicaid
• Third Party Liability (Work comp, MVA, Litigation)
• “Agreements”
– Patient Types
•
•
•
•
ED, STAT, URGENT, SAME DAY ADD-ONS
Procedure changes
Oncology, Mammography, DEXA
Indigent, Homeless, Out-of-network
39
Estimation of Patient Services
– Components and Tools
40
Estimation of Patient Services
– Components and Tools
41
Estimation of Patient Services
– Components and Tools
3. Policy, Procedure, Protocol and Scope(cont.)
Be VERY clear on the following:





who is asked
when the question is posed
what is said
what happens when people refuse or get upset
who is contacted for service recovery
42
Estimation of Patient Services
– Components and Tools
When is the question posed?
•
•
•
•
At Physician’s office?
At Scheduling?
At Reception?
On the Table?
– Earlier and the more frequent, the better
– ELIMINATE SURPRISES
What is said?
• Tailor the conversation to fit the situation…
43
Estimation of Patient Services
– Components and Tools
$
44
Estimation of Patient Services
– Components and Tools
What’s Realistic?
– Scripting is difficult and does not afford
flexibility, however in some cases you must
ensure consistency
– Key Phrases are best where possible
– The 4 “C”’s:
•
•
•
•
Confident
Competent
Compassionate
Collaborative
45
Estimation of Patient Services
– Components and Tools
EXAMPLES:
– Key Phrases
• All of our patients are expected to….
• Do you know what your payment is today?
• We have several options available for payment,
our best is…?
• We typically do ______ when patients ______….
• Most patients elect this option as it….
46
Estimation of Patient Services
– Components and Tools
How much should I ask for??
– Remember the Bull’s Eye
1.
2.
3.
4.
Self-Pay
Indigent Copay
Known Insurance Patient Portion
Unknown Insurance Patient Portion
47
Estimation of Patient Services
– Components and Tools
Strategies to Determine Amounts:
1. Self-pay
•
•
•
•
Take average net-deduction-in-revenue (NDR) and add 510% for “administrative savings”
For example, if block of business has an NDR of 25%,
make the self-pay amount 35%
Take charge master and reduce billed amounts by 35% to
establish Prompt Pay Fee Schedule by Category and/or
line-item CPT
“ALL PATIENTS WHO PAY AT TIME OF SERVICE WHO
DO NOT HAVE INSURANCE ARE ELGIBLE FOR THE
PROMPT PAY DISCOUNT. PAYMENT MUST BE MADE
IN FULL AT TIME OF SERVICE TO BE ELIGIBLE”
48
Estimation of Patient Services
– Components and Tools
Strategies to Determine Amounts:
2. Indigent Amounts
•
•
Program Copay, Coinsurance, Deductibles
Sliding scale to Federal Poverty Level (FPL)
PEOPLES
CLINIC
CICP
DISCOUNT
RATING PLAN
N
C-5
A
C-10
B
C-20
C
C-30
D
C-40
E
C-50
F
C-60
G
C-70
H
C-80
I
C-90
N/A
N/A
Z
N/A
MRI, CAT
WECARE INPATIENT
OUTPATIENT SCAN,
LAB
RATING COPAYMENT SURGERY
NUC MED ER VISIT
WORK
X-RAY
N
$15.00
$15.00
$15.00
$15.00
$5.00
$7.00
A
$65.00
$65.00
$65.00
$25.00
$10.00
$15.00
B
$105.00
$105.00
$105.00
$25.00
$10.00
$15.00
C
$155.00
$155.00
$155.00
$30.00
$15.00
$20.00
D
$220.00
$220.00
$220.00
$30.00
$15.00
$20.00
E
$300.00
$300.00
$300.00
$35.00
$20.00
$25.00
F
$390.00
$390.00
$390.00
$35.00
$20.00
$25.00
G
$535.00
$535.00
$535.00
$45.00
$30.00
$35.00
H
$600.00
$600.00
$600.00
$45.00
$30.00
$35.00
I
$630.00
$630.00
$630.00
$50.00
$35.00
$40.00
J
$1,500.00
$1,500.00
$1,500.00
$200.00 $100.00 $125.00
Z
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
* Peoples Clinic Discount Plan is equivalent to Boulder Community Hospital's WeCare Plan.
*A patient will be charged multiple copays for multiple services done during the same admission or the same visit.
same visit.
49
Estimation of Patient Services
– Components and Tools
Strategies to Determine Amounts:
3. KNOWN insurance amounts
–
Collect what is on the card:
 Copays
 Coinsurance/Deductible
• Estimate allowable amount(s)
• BEWARE of the “floating deductible”
–
–
–
Have patients bring in Benefits Screen Prints/EOBs
Have patients or staff call insurance in advance
ASK patient and collect that
50
Estimation of Patient Services
– Components and Tools
* DATA IS FICTIONAL – NOT ACTUAL CHARGES
51
Estimation of Patient Services
– Components and Tools
Strategies to Determine Amounts:
4. UNKNOWN insurance amounts
•
•
Consider benefits of collection versus
downstream costs to refund
Avoid “over collecting”




•
Customer Service issues
Refund Turn Around Time
Inflated Results
Carrier and Employer “ripple effect”
Credit Card on File
52
Estimation of Patient Services
– Components and Tools
Strategies to Determine Amounts:
Credit Card on File
•
•
Store Credit Card Numbers for subsequent billing
Line of Credit
•
•
•
Compare to when you check into Hotel and they take a
card for “incidentals”
Several vendors offer a software solution that
integrates/replaces existing credit card terminals
BCH Imaging alone generates ~600-700 per
month, or approximately $100K+ in downstream
revenue per month!
53
Estimation of Patient Services
– Components and Tools
Other considerations with Amounts:
– Distribution and communication of amounts
is critical
– Paper or Plastic?
•
•
•
•
Do you have hard copy price sheets, or do you
have software
Version Control
Usability/Math
Accuracy
54
Estimation of Patient Services
– Components and Tools
Other considerations with Amounts:
– Estimators
•
Homegrown
– Spreadsheet, Database, Calculators, Abacus, Paper
» PROs: Cheap and Easy
» CONs: Time investment, Maintenance, Inaccurate
•
Proprietary
– Real-time estimate and/or eligibility
– Configured to managed care contracts
» PROs: Accurate, Fast, Professional
» CONs: Initially can be expensive with
hardware/software, interface/integration
concerns
55
Estimation of Patient Services
– Components and Tools
Other considerations with Amounts:
–
Estimators (Continued):
But we “NEED” this fancy new thingy?!!!
– Prove it:
»
»
»
»
•
Pilot/Trial in focused area to demonstrate value
ROI
Proformas
Customer Service
Huge Opportunities –
–
–
–
several vendors
“buyers market” currently
ROI is typically a matter of months
56
Estimation of Patient Services
– Components and Tools
Estimators (Continued):
•
•
•
•
Determine Risk at front end from Eligibility, Auth,
Benefit/OOP, and propensity to pay
Couple with Credit Scoring to establish eligibility
to other funding mechanisms
Pre-qualify scheduled appointments
Streamline estimation and eligibility checks
57
Estimation of Patient Services
– Components and Tools
58
Estimation of Patient Services
– Components and Tools
ELIGIBILITY AND BENEFITS ESTIMATION TOOL JUSTIFICATION
PROJECTED 2008 - BCH IMAGING
$120,000
NET ADDITIONAL REVENUE 2008: $359,000
$100,000
$80,000
`
$60,000
$40,000
$20,000
$JAN
FEB
MAR
APR
MAY
JUN
REVENUE WITH TOOL
JUL
AUG
SEP
REVENUE WITHOUT TOOL
OCT
NOV
59
DEC
Estimation of Patient Services
Streamlining Workflows
60
Estimation of Patient Services
– Streamling Workflows
Implementation Suggestions:
Test the workflow
Role Play
Roll out in Phases
Focus efforts on simple items first
low-hanging fruit, e.g. uninsured/self-pay
61
Estimation of Patient Services
– Streamling Workflows
Keep it simple…..
– “It is an expectation of your job to ask for
patient portions”
– Ask the simple question – “Do you know your
amount to pay today?”
– Provide Options, NOT ultimatums
– Start small, use paper, then expand to
system-wide integration
62
Estimation of Patient Services
– Streamling Workflows
63
Estimation of Patient Services–
Streamlining Workflows
LOOK BEFORE YOUR LEAP…
Know the amounts (even if a estimates)
before you ask people, to ask patients, for it
Know how you are going to handle and
process the money
Know how to handle customer service issues
and complaints
Know how to defend the mission of the POS
Collections Effort
Know how to adjust the process quickly
64
Estimation of Patient Services
– Streamlining workflows
Workflow Development:
– Develop POLICY to support the
PROCEDURE within the SCOPE of the
project
– Determine:
•
•
•
•
•
When (Specific Steps)
Who (Collection Advisory)
Why (“Doors” and “Bulls eye”)
What (how much $)
How (Scripting/Key Phrases)
65
Estimation of Patient Services –
Streamling Workflows
Opportunity to
communicate
collection efforts
to patient
Patient scheduled and pre-registered
(where possible)
POS COLLECTION
Patient Arrives
WORKFLOW
ADMIT
PATIENT
DRAFT
PRE-REG AND REGISTRATION:




Patient Verification
Order Verification
Insurance Verification
Copay Determination
PRP
REQUIRED
OR SELF
PAY ?
NO
? FINANCIAL
COUNSELOR
ROLE HERE
CURRENT OPTIONS TO DETERMINE/COLLECT PATIENT RESPONSIBILITY
PORTION (PRP)
1. SSI FEED
2. "CHARGE ANTICIPATION" FEE SCHEDULE (IF COINSURANCE EXISTS)
3. MINIMUM COLLECTION OF BILLED($ OR %)
4. CREDIT CARD/BLANK CHECK
YES
SEE SCRIPT
FINANCIAL
RESOLUTION
ACHIEVED?
SELF-PAY:PATIENT INSTRUCTED
THAT EXAM RESCHEDULED
NO
INSURED: ATTEMPT COLLECTION,
ALLOW EXAM IF UNABLE TO PAY,
REINFORCE POLICY
YES
REQUEST PAYMENT/
SIGNATURE
(SEE SCRIPT)
Enter Tests to be
Performed
EXAM
PERFORMED
66
Estimation of Patient Services –
Streamlining workflows
EXAM
SCHEDULING
COMPLETE
START
POS COLLECTIONS
YES
SELF-PAY?
Scheduling / PreRegistration Workflow
NO
PRP collections
active?
NO
DNC LIST?
YES
POS COLLECTIONS
BYPASS ALL
RECEPTION
WORKFLOW
NO
SR: "Did your insurance company determine
the patient portion of your exam today?"
NO
YES
SR = SERVICE REPRESENTATIVE (RECEPTION)
YES
AMOUNT
KNOWN?
YES
DNC LIST?
PT
PORTION?
YES
YES
SR: "Great. How would you like to pay this
amount today, by Credit Card or Check"?
(ISR verifies amount)
NO
NO
NO
Patient/
Physician /Faxed
Order ?
Physician/Faxed
Order
SCHED/PRE-REG AWAITS
PATIENT TO CALL FOR
SCHEDULED TIME (IF TIME
PROVIDED BY PHYSICIAN
OUTBOUND CALL WILL BE
NECESSARY BY
SCHEDULING / PRE REG)
YES
Patient
BYPASS ALL
Scheduler: "BCH expects payment of the Patient Responsibility Portion (PRP) for exams at the
time of service. If you have insurance, we encourage you to contact your insurance company
prior to your appointment to determine your insurance benefits and any out-of-pocket expense
for your exam. Please bring information from your insurance company (last explanation of
benefits from insurance (EOB), on-line print screen, etc) that indicates the amount you owe for
your exam. We will be collecting that patient portion of your exam when you arrive for your test,
in the form of a credit card, personal check, or cash. If you cannot determine your portion, or
are a self-pay patient, we can estimate the amount that we will be collecting. [use pricer or
estimated cost of care down payments] If your PRP cannot be easily determined, a credit card
imprint will be obtained to bill for your portion once determined."
CREDIT
CARD?
YES
NO
Pt: "I don't have a credit card."
Scheduler: "Thank you, we will
collect payment in that form. If you
have insurance, make sure you
check with your insurance before
you come in. We will see you for
your [exam] at [time] on [date] at the
[facility] Campus. Is there anything
else I can help you with today?"
Y/N?
YES
Scheduler:
NO "Have a nice
day" (Call ends)
YES
NO
cash?
NO
Additional billing
questions?
ESTIMATE /
CCI / NONE ?
COVERAGE
AMOUNT
DETERMINED?
NO
Place
appointment
in "Pending"
Scheduler: "Let me transfer you to our
financial counselors at (303) 440-2139 (or
other area as appropriate) to address your
questions. Please call us back once your
questions have been answered and we will
complete the scheduling of your exam. Thank
you for your patience."
(Call transferred to appropriate area)
NO
IF INSURED, REINFORCE POLICY. BILL WILL
BE SENT, PAYMENT WILL BE EXPECTED
NEXT TIME, AND EXAM CAN OCCUR.
IF SELF PAY, SEE NEXT PAGE
NONE
CCI
NO
Yes
CREDIT
CARD?
Yes
NO
Yes
SR; "W e collect "x"
YES
(SR REVIEWS
INSURANCE INFO WITH
PATIENT AND MAKES
ANY NECESSARY
CHANGES)
SR: "I can estimate the amount for you based off of some
information we have from various insurance companies and our
charges. If you are not comfortable with an estimate, we collect an
imprint of a credit card to allow the hospital to bill for your portion of
your exam(s) today. That portion will be determined after the claim
is submitted to your insurance company, in approximately 60 days.
Ten days prior to that time, the billing office will send you a letter to
notify you of the amount and charge it to your credit card. This will
allow you time to review your charges prior to them being billed.
ESTIMATE
Scheduler: "If you do not have a credit
card, we can accept a personal check"
Personal
Check?
SR: "I would like to go over the insurance information you
have provided so far to make sure we complete and
accurate information to file a claim with your insurance
company. Let's go over this, and please feel free to
interrupt me if you don't understand something."
amount for the test
you are receiving
today(refer to Pricer or
Estimated Cost of
Care Downpayment).
We can accept
payment via cash,
credit card or check. "
PT: "Yes, I have
my Credit Card"
SEE NEXT PAGE
For unknown amounts with a CCI, SR takes the credit card and imprints it,
writing "[AREA] EXAM - PATIENT PORTION" in the description field of the
Credit Card Slip. The CUSTOMER copy is given to the patient, and the
MERCHANT copy is attached to a face sheet. The Credit Card Slip is
hand delivered to the PBA and held until the account is processed. Note:
Known amounts are processed through the credit card machine and
posted into the Cashier Drawer.
SR: "Thank you. I
will prepare your
receipt"
END
SR: "Thank you again, and if you have any questions,
please contact our billing department at (303) 544-5744"
Patient is provided with a "Copay
Collection information sheet"
67
Estimation of Patient Services
– Streamlining workflows
Be prepared to handle the
following scenarios with patients:
 They may not have their wallet
 They may not have their ins card
 Their may not have cash on hand
 They may not have credit cards
 Their deductible may be too high
68
Estimation of Patient Services–
Streamlining workflows
COPAY COLLECTION
TASK FORCE
RECEPTION WORKFLOW
(continued - NO CREDIT CARD, NO
CHECK, NO CASH - RESCHEDULE IF
SELF-PAY)
NO CASH OR
PERSONAL CHECK?
PT: "I do not want to pay with a
check at this time." OR "I do not
wish to pay a copay at this time".
No
YES
SR: "I understand. We must
collect a credit card imprint or
check for the estimated payment
portion to bill more efficiently.
SEE PRIOR PAGE
[**** IF PATIENT OR PHYSICIAN
INDICATES EXAM IS AN EMERGENCY (I.E.
STAT EXAM), AND INDICATES THEY ARE
UNABLE TO PAY, CONTACT THE SITE
MANAGER, DIRECTOR, OR SUPERVISOR TO
DETERMINE IF EXAM NEEDS TO BE
PERFORMED TODAY. IF A SUPERVISOR,
MANAGER, OR DIRECTOR IS NOT
AVAILABLE, ALLOW APPOINTMENT TO BE
PERFORMED. IN CASES WHERE THE EXAM
IS DEEMED AN EXCEPTION THOUGH
ABOVE THEN DOCUMENT, “EXAM IS
DEEMED MEDICALLY EMERGENT”, IN THE
BLUE COMMENTS FIELD OF THE
REGISTRATION SCREEN, PRINT IT, AND
PROVIDE TO SITE MANAGER OR
DIRECTOR. ALSO DOCUMENT EXCEPTION
ON EXCEPTION LOG.]
INSURED PATIENTS:
Please be aware that a bill will be sent to you
outlining the charge(s) for the procedure(s)
performed today. Payment in full will be
expected at that time. At your next visit,
please be prepared to pay for your exam(s)
before services are rendered. [REFER TO
FINANCIAL COUNSELING/PBA IF FURTHER
FINANCIAL ASSISTANCE IS NEEDED
SELF-PAY CICP/WECARE:
Unfortunately, we cannot perform your
exam unless you provide us payment.
Would you like to speak with Financial
Counseling at x2139? (303) 440-2139?
You can reschedule your exam after you
have made arrangements for payment.
[Provide numbers and “commonly asked
questions sheet”]
ISR: "Is their anything else I
can help you with today"
(ISR provides patient with a Copay Collection
Form and addresses any outstanding issues)
69
Estimation of Patient Services
– Streamlining workflows
EXAM
SCHEDULING
COMPLETE
POS COLLECTIONS
Scheduling / PreRegistration Workflow
NO
PRP collections
active?
YES
YES
DNC LIST?
POS COLLECTIONS – QUICK SCRIPT
NO
Patient/
Physician /Faxed
Order ?
Physician/Faxed
Order
Scheduling/Pre-reg
SCHED/PRE-REG AWAITS
PATIENT TO CALL FOR
SCHEDULED TIME (IF TIME
PROVIDED BY PHYSICIAN
OUTBOUND CALL WILL BE
NECESSARY BY
SCHEDULING / PRE REG)
1. PHYSICIAN/OFFICE:
Insured Patient:
Patient
BYPASS ALL
SR: "BCH expects payment
of the Patient Responsibility Portion for exams at the time
of service. We encourage patients to contact their insurance company prior to their
Scheduler: "BCH expects payment of the Patient Responsibility Portion (PRP) for exams at the
appointment to determine insurance benefits and any out-of-pocket expense for their exam. We
time of service. If you have insurance, we encourage you to contact your insurance company
be collecting that patient portion when they arrive for their test, in the form of a credit card,
prior to your appointment to determine your insurance benefits and any out-of-pocketwill
expense
for your exam. Please bring information from your insurance company (last explanation
of
personal
check, or cash. Please inform your patient of this policy. Thank you.”
benefits from insurance (EOB), on-line print screen, etc) that indicates the amount you owe for
your exam. We will be collecting that patient portion of your exam when you arrive for your test,
Self-Pay
/ CICP / WECARE Patient:
in the form of a credit card, personal check, or cash. If you cannot determine your portion,
or
are a self-pay patient, we can estimate the amount that we will be collecting. [use pricer or
estimated cost of care down payments] If your PRP cannot be easily determined, a credit
SR: "card
Payment in full is required prior to services being rendered. There is a discount
imprint will be obtained to bill for your portion once determined."
CREDIT
CARD?
YES
Scheduler: "If you do not have a credit
card, we can accept a personal check"
YES
Personal
Check?
YES
NO
cash?
NO
Additional billing
questions?
START
check with your insurance before
you
in. We will see you for
2. come
PATIENT:
your [exam] at [time] on [date] at the
[facility] Campus. Is there anything
Insured
else I can
help youPatient:
with today?"
NO
Pt: "I don't have a credit card."
Place
appointment
in "Pending"
To see the binder spines, turn to page 2 of this publication.
program available, where if paid at time of service, a discount off the price can be applied. If
payment in full is not received at the time of service, this discount may be less or after 30 days,
Scheduler: "Thank you, we will
available.
WeIfencourage
your patient to contact us as soon as possible to discuss payment
collectnot
payment
in that form.
you
options regarding
their exam(s). Please inform your patient of this policy. Thank you.”
have insurance,
make sure you
YES
SELF-PAY?
NO
DNC LIST?
YES
POS COLLECTIONS
NO
RECEPTION
WORKFLOW
SR: "Did your insurance company determine
BYPASS ALL portion
SR: " Do you happen to knowtheyour
benefit
or patient responsibility
patientinsurance
portion of your
exam today?"
Scheduler:
for the exam(s) that
have been ordered for you?” [If “YES” SKIP TO OPTION
Y/N?
NO "Have a nice
(1)]"BCH
expects
payment of the Patient
Responsibility
Portion for exams at the time
NO
YES
day" (Call ends)
SR = SERVICE REPRESENTATIVE (RECEPTION)
of service. We encourage you to contact your insurance company prior to your appointment to
YES
determine your insurance benefits and any out-of-pocket expense for your exam. Please bring
Scheduler: "Let me transfer you to our AMOUNT
PT from insurance
SR:(EOB),
"Great.onHow would you like to pay this
information
your
insurance
company (last explanation
of benefits
YES
YES
financial
counselorsfrom
at (303)
440-2139
(or
KNOWN?
PORTION?
amount today, by Credit Card or Check"?
other
area
as appropriate)
to address
your
line
print
screen, etc)
that indicates
the amount you owe for your exam. We will be collecting
questions.
Please call
us back
that patient
portion
ofonce
youryour
exam when you arrive for your test, in the form of a credit card, (ISR verifies amount)
NO
questions have been answered and we will
personal check, or cash.
NO
complete the scheduling of your exam. Thank
[3 OPTIONS – (1) USE AMOUNT PROVIDED, (2) ESTIMATE AMOUNT, (3) CREDIT
you for your patience."
(Call transferred
to appropriate
area)
CARD
IMPRINT]
SR: "I would like to go over the insurance information you
(SR REVIEWS
have provided so far to make sure we complete and
INSURANCE INFO WITH
accurate
information to file a claim with your insurance
Self-Pay / CICPYES
/ WECARE
Patient:
PATIENT AND MAKES
company. Let's go over this, and please feel free to
ANY NECESSARY
CHANGES)
interrupt me if you don't understand something."
POS COLLECTIONS – QUICK SCRIPT
Scheduling/Pre-reg
1. PHYSICIAN/OFFICE:
Insured Patient:
SR: ”Payment in full is required prior to services being rendered. There is a discount
program available, where
paid
at time
service,
a based
discount
the price can be applied. If
SR: "Iifcan
estimate
the of
amount
for you
off ofoff
some
from various
insurance
our available. Please wait a
payment in full is notinformation
received we
at have
the time
of service,
thiscompanies
discountand
is not
charges.the
If you
are notfor
comfortable
with aninestimate,
we collect
an
moment while I determine
charge
the exam(s)
which you
are receiving
”
NO
imprint of a credit card to allow the hospital to bill for your portion of
SR: "BCH expects payment of the Patient Responsibility Portion
for exams at the time
your exam(s) today. That portion will be determined after the claim
of service. We encourage patients to contact their insurance
company
prior to
theirinsurance
[ESTIMATE
CHARGE(S)
EXAM AND
PROMPT
PAY DISCOUNT]
is submitted
toFOR
your
company,
in approximately
60 days.
appointment to determine insurance benefits and any out-of-pocket expense
for their
Ten days prior
to thatexam.
time, theWe
billing office will send you a letter to
you
of the
charge it to your creditThe
card.charge
This will for this exam is $xxx.
will be collecting that patient portion when they arrive
for their
thebe
form
of amount
a credit
SR: “The
examtest,
thatinnotify
will
performed
isand
a card,
[PROCEDURE].
allow you time to review your charges prior to them being billed.
personal check, or cash. Please inform your patient
this policy.to Thank
It isofdiscounted
$xxx ifyou.”
paid at the time of service per the discount policy I mentioned earlier.
Again, please note that this discounted price only applies if the amount
is paid in full
IF INSURED, REINFORCE POLICY. BILL WILL
Self-Pay / CICP / WECARE Patient:
prior to services being rendered.
ESTIMATE /
BE SENT, PAYMENT WILL BE EXPECTED
ESTIMATE
NONE
NEXT TIME, AND EXAM CAN OCCUR.
IF SELF PAY, SEE NEXT PAGE
CCI / NONE ?
SR: " Payment in full is required prior to services being rendered. There is a discount
CCI
COVERAGE
NO If
program available, where if paid at time of service, a discount off the price can
be applied.
AMOUNT
payment in full is not received at the time of service, this discount may be DETERMINED?
less or after 30 days,
not available. We encourage your patient to contact us as soon as possible Yes
to discuss payment
options regarding their exam(s). Please inform your patient of this policy. Thank you.”
CREDIT
CARD?
2. PATIENT:
Insured Patient:
Yes
Yes
SR; "W e collect "x"
amount for the test
you are receiving
PT: "Yes, I have
my Credit Card"
today(refer
to Pricer or
SR: " Do you happen to know your insurance benefit or patient
responsibility
portion
Estimated Cost of
for the exam(s) that have been ordered for you?” [If “YES” SKIP
TO OPTION
Care Downpayment).
We canfor
accept
(1)]"BCH expects payment of the Patient Responsibility Portion
exams at the time
NO
NO
payment via cash,
SR: "Thank
of service. We encourage you to contact your insurance company prior
to your appointment
to you. I
credit card or check. "
will prepare your
determine your insurance benefits and any out-of-pocket expense for your exam. Please bring
receipt"
information from your insurance company (last explanation of benefits from insurance (EOB), online print screen, etc) that indicates the amount you owe for your exam. We will be collecting
that patient portion of your exam when you arrive for your test, in the form of a credit card,
SR: "Thank you again, and if you have any questions,
personal check, or cash.
please contact our billing department at (303) 544-5744"
[3 OPTIONS – (1) USE AMOUNT PROVIDED, (2) ESTIMATE AMOUNT, (3) CREDIT
CARD IMPRINT]
SEE NEXT PAGE
For unknown amounts with a CCI, SR takes the credit card and imprints it,
writing "[AREA] EXAM - PATIENT PORTION" in the description field of the
Credit Card Slip. The CUSTOMER copy is given to the patient, and the
MERCHANT copy is attached to a face sheet. The Credit Card Slip is
hand delivered to the PBA and held until the account is processed. Note:
Known amounts are processed through the credit card machine and
posted into the Cashier Drawer.
END
Patient is provided with a "Copay
Collection information sheet"
Point of Service (POS)
Collections Manual
Self-Pay / CICP / WECARE Patient:
SR: ”Payment in full is required prior to services being rendered. There is a discount
program available, where if paid at time of service, a discount off the price can be applied. If
payment in full is not received at the time of service, this discount is not available. Please wait a
moment while I determine the charge for the exam(s) in which you are receiving ”
[ESTIMATE CHARGE(S) FOR EXAM AND PROMPT PAY DISCOUNT]
SR: “The exam that will be performed is a [PROCEDURE]. The charge for this exam is $xxx.
It is discounted to $xxx if paid at the time of service per the discount policy I mentioned earlier.
Again, please note that this discounted price only applies if the amount is paid in full
prior to services being rendered.
Jonathan Wiik
PH: (303) 440-2049
PG: (303) 509-0176
E-mail: [email protected]
Version 1— 6/13/06
70
Estimation of Patient Services
TRAINING FRONT LINE STAFF
71
Estimation of Patient Services
– Training
• Be empathetic not sympathetic
– understand patient’s situation but pursue reasonable
payment options with the patient
• Put yourself in the patient’s shoes
– how would you want the situation explained, presented and
handled?
• We must be sincere when empathizing with the
patient
Overwhelming The Bad Debt Crisis - HWORKS
72
Estimation of Patient Services
– Training
How Do You Request For Payment In Advance?
• Registrars must choose their words carefully and be
respectful, yet be direct with the patient
• Registrars need to be aware of their tone of voice
when speaking with the patient
• Be firm about hospital policy and reassure the patient
that paying in advance is for their benefit
Overwhelming The Bad Debt Crisis - HWORKS
73
Estimation of Patient Services
– Training
“The goal of the BCH POS Collections Program is not to
collect money. Our goal is to educate patients as to
the costs of their care, and help them navigate these
costs”
‘Boulder Community Hospital strives to help patients
understand their health care costs. In that effort,
coverage is verified, costs are discussed, and payment
arrangements are made - in advance. Through this,
bad debt is reduced and the operations of our hospital
remain financially viable to continually serve our
community”
74
Estimation of Patient Services–
Training
“I never had to pay at time of service before.”
REGISTRAR RESPONSE
I understand that you may have not been asked
before. Since you were here last, we have made
changes to our processes that no longer allow us
to delay collecting payments. Also, there are
many advantages of paying up-front. Foremost,
you know the costs of your health care upfront,
and we can process your payment using a variety
of options available to you right now. How would
you like to pay today? We accept check, cash,
credit cards.
75
Estimation of Patient Services
– Training
Incentive Plans
 Health Care is moving to retail, business-like atmosphere
Should not pay people to their jobs, it is an expectation
Award successes and good performance
Set awards at roughly 3-6% of salary
Incentives work, but are risky
Ensure Longevity of plan before launching
Large Policy and procedure
76
POS COLLECTIONS
– Training
INCENTIVE AS COMPARED TO CCI ADJ COLLECTIONS
$140,000
$1,600
$1,400
$120,000
$1,200
$1,000
$80,000
$800
$60,000
AWARD PAYOUT
POS COLLECTIONS
$100,000
$600
$40,000
$400
$20,000
$200
$-
$JAN
FEB
MAR
APR
MAY
JUN
CCI ADJ $
JUL
AUG
SEP*
OCT*
NOV*
DEC*
AWARD
77
Estimation of Patient Services
Conclusion
78
Estimation of Patient Services
– Closing Thoughts
In Summary…
– Critically analyze market trends and evaluate best practices
– Adopt what would work well in your organization
– Identify the components and scale the project to the
resources you have available
– Train, retrain, and adapt the workflows
– Educate your coworkers, customers, and community
79
Estimation of Patient Services–
Closing Thoughts
Develop a Strategy and Collection
Mechanism that is:
Easily deployed
Elegant and simple
Flexible by role and patient type
Supported by management
Scalable
80
Estimation of Patient Services
- Closing Thoughts
Have clear direction and momentum:
1. Have a meeting

2.
3.
4.
5.
6.
7.
8.
At an early stage, ensure to include the people who are
going to ask people for their money
Assemble a team
Build from existing workflows and add to them
Develop the “plan”
Test the workflows and track your results
Discuss Challenges and Celebrate Successes
Lead by example
Do not ever give up
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Estimation of Patient Services
- Closing Thoughts
THANK YOU
Questions?
Jonathan G. Wiik, MSHA, MBA
Val Kraus, MBA
Imaging Operations Manager
Director of Admissions and Case Management
Boulder Community Hospital
Boulder Community Hospital
(303) 440-2049
(303) 440-2124
[email protected]
[email protected]
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