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Panel Discussion AAHAM Fall 2014 Conference October 2-3, 2014 Key Components Required to Meet Your Collection Objectives Foundational Processes ● Quality assurance system and process controls ● Account workflow, including dispute management ● Obtaining results with technology for patient engagement Commitment to Patient Satisfaction ● Established policy of no complaints and improved patient experience ● Call monitoring and established dispute protocols Commitment to Performance ● Organizational goals aligned with provider goals and routine communication of measured results Achieving the primary goals ● Values alignment between the agency and the provider ● Commitment to education Industry specific training opportunities Tracking first call resolution ● Commitment to data and speech analytics ● Quality Control as a foundation of the organization Foundational Processes: Controls for Quality Results Quality management system based on ISO 9000 Drives quality and continuous improvement processes Consumer Financial Protection Bureau(CFPB) – dispute-tracking requirements Measurements Training Continuous Improvements Documentation Auditing Client Issues & Non-Conformities Foundational Processes: Results through Technology Collection software with account tracking and work queue capabilities as well as an integrated autodialer Fully-integrated predictive dialing and call recording 24/7 online portals and IVR for patient account access and payments Speech Analytics quality assurance/training Utilization of data analytics/scoring tools Document imaging and management allowing for ease-of-access to necessary information including client-provided and electronicallyrecreated itemized statements Commitment to Performance: Collection Processes Commitment to Patient Satisfaction: Advanced Speech Analytics & Quality Scorecards The Dashboard views above provide a re-cap of the weekly activity. Speech Analytics allows us to further research the specific agent and listen to the call and see the text of both sides of the conversation. Commitment to Patient Satisfaction: Dashboards Presence of Courtesy Language (goal of 95% or greater) Longest Hold Time (goal of 15 seconds or less) 102.00% 100.00% 98.00% 96.00% 94.00% 92.00% 90.00% 88.00% 25 20 15 10 5 0 Month Month Month Month Month Month Month Month 1 2 3 4 5 6 7 8 Month Month Month Month Month Month Month Month 1 2 3 4 5 6 7 8 First Call Resolution Rate (goal of 80% or greater) 105.00% 100.00% 95.00% 90.00% 85.00% 80.00% 75.00% Month Month Month Month Month Month Month Month 1 2 3 4 5 6 7 8 Commitment to Patient Satisfaction: Dashboards Percent of Risk Language Percent of Supervisor Calls 5.00% 4.50% 4.00% 3.50% 3.00% 2.50% 2.00% 1.50% 1.00% 0.50% 0.00% 1.20% 1.00% 0.80% 0.60% 0.40% 0.20% 0.00% Month 1 Month 2 Month 1 Month 3 Month 2 Month 1 Month 2 Month 3 Calls > 2 minutes 11,986 9,640 8,678 Supervisor Calls 79 72 98 Risk Language 408 388 410 Month 3 Definition: Supervisor calls defined by patients requesting to speak to a supervisor or manager. Risk language calls are those that contain predetermined words or phrases associated with dissatisfaction such as “Speak to CEO”, “Contact President of Hospital”, expletives, etc. All calls are analyzed to improve overall patient satisfaction and identify training needs. Commitment to Performance: Aligned Collection Philosophy Employee Pledge I believe every person has worth as an individual. I believe every person should be treated with dignity and respect. I will make it my responsibility to help consumers find ways to pay their just debts. I will be professional and ethical. I commit to honoring this pledge. _____________________ (Employee Signature) _______________________ (President Signature) Commitment to Performance: Patient Account Representative Staffing Dedicated collections staff Cross training of overflow group Hours of operation are 8a to 9p Familiarity with your patients Client-specific training materials Staffing adjusted based on inventory analysis Scoring analytics and skip trace strategies Segmentation strategies including balance range Dialer management – primary and secondary groups based on inventory fluctuations and call times Compliance with your requirements Patient-friendly approach Treating all patients with dignity and respect Zero tolerance for complaints Charity care/financial assistance identification Recreation of itemized statements Bilingual specialists and language line Collector compensation structure Measurement goals based on performance model and monthly QA bonus Commitment to Performance: Tying it All Together Measuring the Results of Using an Agency Partner Measuring the Results of Using an Agency Partner ABC Hospital Self Pay Total (over 90 days) $3,500,000 Client had previously outsourced with another agency. AR over 90 days has reduced by 30% in Year 2 over Year 1. $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000 ABC Hospital A/R Receipts $500,000 $0 $70,000.00 $60,000.00 True Self Pay receipts have increased by 26% when comparing Year 2 to Year 1 averages. $50,000.00 $40,000.00 $30,000.00 $20,000.00 $10,000.00 $0.00 A Collection Process Objectives Checklist Vendor yield improvement Reduce overall collection costs (improve net back) Maintain a high level of customer service for patients Establish an integrated and seamless patient experience, including staff performance monitoring and service levels Partner with a “best practice” agency Understand and review of legal activities Thank You! Martha Henes, Insurance Discovery Supervisor Phone: (800) 477-7474 Email: [email protected]