Improving Time of Service Collections

Article by Richelle Cox, COO Arrowlytics

The landscape of healthcare is changing. Patients are faced with insurance plans that have high out-of-pocket deductibles and costly copay and co-insurance requirements. The days of relying on insurance companies to cover the majority of the costs associated with patient care are ending, and more of the expense responsibility is falling directly to the patient. Collecting the amount the patient owes at their visit, and collecting the patient’s responsibility prior to costly tests and procedures, is critical to keeping practice revenue stable and limiting your group’s days in AR.


Tips to Improve Collections

  1. Inform Your Patients
    Out-of-pocket costs are driving patients to be more educated about their healthcare expenses. They want estimates for high dollar procedures, and they want to know what they are going to be expected to pay when they leave the doctor’s office. There are Practice Management systems and supplemental applications that assess a patient’s allowable based upon the patient’s actual insurance coverage. This helps ensure your team can better estimate what a patient will owe and allows your team to set expectations and answer questions before the patient receives services. Having those allowable amounts populate your Practice Management system ensure you can report on your actually time of service collections.
  2. Evaluate Hiring Practices
    As groups begin to monitor their time of service collection performance, many uncover a need to retrain staff. However, some find that they really do not have the right team member working to collect from the patient. Healthcare collections requires someone who is well trained and very extroverted. It’s difficult to collect from patients who may be chronically ill, or in a lot of pain. Employees who lack confidence or who are not well trained may struggle to be successful in that role. Getting the right people in that role starts with the hiring process. Work with your HR team to identify validated screening tools that will allow you to replicate a good hire over and over in those patient facing roles!
  3. Measure Your Progress
    There are a number of factors that could negatively impact your group’s time of service collections, even if you have a history of doing well in that area. A sudden shift in payor mix due to a new large employer in your community, or merging your group with a partner group who did not have good collection practices, are just two examples of drivers that can cause your time of service collections to drop unexpectedly. Spotting checking your time of service collections is not sufficient. You need daily monitoring so your management team can react quickly to avoid the heavy costs of collecting after the patient leaves your office.
  4. Incentivize Progress
    Timely collecting needs to be a part of your company’s culture. Measuring your progress will allow you to assess your success and set clear targets for your team. Setting clear collection policies and tying incentives to the successful execution of those policies will ensure you staff and management teams are focused on the company’s strategic initiatives around collections.


What should you be monitoring?

There are four key areas to focus on when you begin to measure how your group is performing relative to time of service collections.

  1. Office Based Time of Service Collections
    Accurately measure how well or poorly your practice is doing collecting at the time of the visit requires that you document what the patient owes upon checkout and what he or she paid that day. Ideally this information will be housed in your Practice Management System or be passed to that application from a third party tool that will determine the patient responsibility for your services.
  2. Pre-Collection for Tests & Surgical Procedures
    High deductible plans are making it more difficult for providers to be paid the full allowable amount for their costlier services, like surgical procedures or MRIs, in a timely manner. Much like office collections, it’s critical for groups to have visibility to discrete data on each patient that shows the allowable amount and the amount collected.
  3. Time of Service Collections Benchmarking
    There is value in having visibility to how your group, or even a single practice location, is performing. Being able to benchmark against other similar practices is truly priceless information! Practices who currently find themselves evaluating a report from their Practice Management system are often left to wonder if their collection percentages are great or just mediocre. Having access to data from other groups will let you accurately assess your current state and measure your success against.
  4. Staff Level Detail
    Knowing you have poor collection practices across the group, or at a single location, isn’t helpful unless you are able to track it to a staffing level so you can target necessary training. Knowing which of your employees are appropriately collecting allows your management team to more quickly identify and deploy best practices throughout your organization.


Data Analytics Tools and How They Help

Most Practice Management systems provide pre-defined reports that may give you some visibility to how your practice is doing relative to collecting from patient’s at the time of service. Often these reports are only available to a select group of individuals in the practice who must rely on email and communications in meetings to disseminate the information contained in the reports to other members of their team. Normally these reports are also just a snapshot in time, and do not offer a higher level look over time that allow you to react quickly to changes in your time of service collections. Trending is often limited or not available at all natively out of the application.

A dashboard gives your team daily visibility to all of the areas mentioned above. At Arrowlytics, we extract all of the necessary information from your Practice Management system to give your team the information they need to drive and monitor best practices in your organization. Data visualization is important. Managers who are responsibility for your company’s goals need to know immediately when they fall behind your company’s collection goads. Our graphical representations of your data do just that and your managers will see changes to their trends every day. Additionally, we provide detailed information, at a cashier level, so your training and reeducation efforts can be targeted and specific.


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