Transcript Document
SELF PAY COLLECTION GUIDELINES
Julie Smith
We don’t do Point of Service Collections Guarantor balance drives follow up process How do we differ?
Propensity to pay drives follow up process Phone call initiates collection and Financial Assistance process quicker Patient friendly scripting used in phone calls Initial phone call made shortly after discharge
Current Self Pay Follow up criteria Guarantor Balance > $1,000
Admission • All self pay patients screened by vendor for coverage • MA, TPL, Crime Victims, etc.
5 Days Post Discharge • Summary Bill drops to patient 7 Days Post Discharge • System runs credit score and moves account into Collector work queues
Current Self Pay follow up criteria Guarantor Balances > $1,000
>7 Days Post Discharge • Call patient/guarantor and follow initial collection call script Able to Reach Patient • Collect outstanding balance and/or set up payment arrangement • If patient can’t meet acceptable payment arrangement, screen for financial assistance.
Not Able to Reach Patient • Make 2 nd attempt within 48 business hours • Day 21 – Account falls into collection work queue. Attempt call to patient/guarantor.
Initial Collection Call Script
Collector: Hello, my name is ______ and I am calling from XYZ Hospital. Our records indicate that you do not have insurance coverage and I just wanted to call and confirm that. If you do have coverage we would be happy to assist you with the billing.
Patient confirms they have no coverage
Collector: A summary bill was mailed out on ____ did you receive the bill? I’d like to explain that the bill you received from us is for hospital services only. All physicians bill separate (example: ER Physician, Radiologist, Surgeons, etc.) so you could be getting multiple bills from this visit depending on what your services were. Did you have any questions on our bill?
Because you have no insurance coverage you received a 25% uninsured discount which is reflected on your bill. We also offer a 10% prompt pay discount which is good until _____. Would you like to take care of this bill today as I can take your payment over the phone.
If they are unable to pay in full today try to establish an acceptable payment arrangement.
If they cannot pay the bill off within 10 monthly payments:
Explain our Helping Hands Lending program which offers longer term payment plans.
If the patient complains about affordability then you will need to screen them for Financial Assistance.
Collections on Self Pay after Insurance Collection criteria is very similar to true Self Pay. The only difference is the initial call is made 20-30 days after patient has received their first statement.
Follow up is based on Guarantor balance and propensity to pay.
Briefly explain how the Financial Assistance program works:
Good for 6 months Discounts from 55% up to 100% based on income/assets Partial discounts would allow for smaller payments spread out over our interest free payment plan.
Some other physician offices honor our Financial Assistance (patient responsible for checking with other providers) Financial Assistance is good for both hospitals in our division
Patient response: I have insurance coverage Collector response: OK, I can take that information from you and we would be happy to handle the billing for you.
Take all information and follow process for new insurance information received.
Current Self Pay Follow up criteria Guarantor Balances > $1,000
Good/Excellent Credit Score • Day 21 – Send LTRA with payment options • Day 51 – Call patient/guarantor. If no contact sent LTRB • Day 81 - Balance < $5,000 – Send LTRC Balance > $5,000 – Call patient/guarantor if no contact send Financial Assistance application • Day 111 – If no contact send to Bad Debt Poor Credit Score • Day 21 – Send letter with Financial Assistance application • Day 51 – If no contact send LTRA • Day 81 – If no contact send LTRB • Day 111 – If no contact send LTRC • Day 121 – Review for Financial Assistance or charge off
Current Self Pay follow up criteria Guarantor balances $500 - $999.99
5 days post discharge • Summary Bill drops to Patient/Guarantor 7 days post discharge • System runs credit score and moves account into Collector Work Queues • Call patient/guarantor and follow initial call script.
Able to Reach Patient • Collect outstanding balance and/or set up payment arrangement • If patient can’t meet acceptable payment arrangement, screen for financial assistance. If potentially eligible send application.
Not Able to Reach Patient • Good/Excellent Credit Score • Send LTRA with payment options • Poor Credit Score • Send Financial Assistance App licatio n
Current Self Pay follow up criteria Guarantor balances $500-$999.99
Good/Excellent Credit Score • Day 21 - Call patient/guarantor • Day 51 – If no contact send LTRB • Day 81 - Send LTRC • Day 91 – Recommend for Bad Debt Poor Credit Score • Day 21 – If Financial Application is not received send LTRA • Day 51 – Send LTRB • Day 81- Send LTRC • Day 91 – Financial Assistance likely
Current Self Pay follow up criteria Guarantor balances $200 - $499.99
5 days post discharge • Summary bill drops to patient/guarantor Day 30 • 1 st Guarantor statement mailed to patient/guarantor • Send LTRA with payment options Day 60 • 2 nd Guarantor statement mailed to patient/guarantor • Send LTRB Day 90 • 3 rd and final guarantor statement is mailed to patient/guarantor • Send LTRC Day 100 • Recommend for Bad Debt
Current Self pay follow up criteria Guarantor balances < $199.99
5 days post discharge date • Summary bill mailed to patient/guarantor Day 30 • 1 st Guarantor statement mailed to patient/guarantor Day 60 • 2 nd Guarantor statement mailed to patient/guarantor Day 90 • 3 rd and final guarantor statement mailed to patient/guarantor Day 120 • Account is reviewed for Bad Debt
Customer satisfaction Staff satisfaction Our goal is to reduce aged Self Pay by 10% Less time spent on collecting from patients who can’t/won’t pay.
New Collection Process results More time spent on collecting from patients who can/will pay Financial Assistance applications processed quicker
Thank you!
Questions?