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Marie Yarborough – Improving Patient Collections: Proven Strategies
71 Plays23 days ago
Welcome to the third and final episode of our series on Improving Patient Collections! Over the past two episodes, we’ve explored mastering eligibility and shared valuable tips for post-date of service collections. Today, we’re excited to bring you insights from Marie Yarborough, the administrator at Sequoia Surgical Pavilion in Walnut Creek, California. With over 15 years of experience in healthcare administration, Marie has a wealth of knowledge when it comes to optimizing patient collections. In this episode, she’ll dive into key strategies for upfront collections, how third-party financing can help, the impact of the No Surprises Act, and how technology is transforming the process.
In our news recap, we’ll cover growing concerns from various ASC leaders, a new hospital price transparency bill that if passed will impact ASCs, Walmart’s new pharmacy delivery initiative, and, of course, end the news segment with a positive story about three nurses who went viral for their new CPR training technique.
Resources Mentioned:
ASCs sound alarm on mounting threats
New Hospital Price Transparency Bill in Pennsylvania Could Impact ASCs
Walmart adds pharmacy to same-day delivery
Texas Nurses Rock CPR: Using Sabrina Carpenter’s Hit to Save Lives
Brought to you by HST Pathways.
Recommended
Transcript
Intro to Podcast & Episode Overview
00:00:01
Speaker
Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guests, and then we'll close the episode by recapping the latest news impacting surgery centers. We're excited to share with you what we have, so let's get started and see what the industry's been up to.
00:00:27
Speaker
Hi, everyone. Here's what you can expect on today's episode. This is the third and final episode of our series on improving patient collections. Over the past two episodes, we've explored mastering eligibility and shared valuable tips for post-data service collections.
Expert Insights with Marie Yarbrough
00:00:44
Speaker
Today, I'm excited to bring you insights from Marie Yarbrough, who is the administrator at Sequoia Surgical Pavilion in Walnut Creek, California. With over 15 years of experience in healthcare administration, Marie has a wealth of knowledge when it comes to optimizing collections. In this episode, she dives into key strategies for upfront collections, how third-party financing can help, the impact of the No Surprises Act, and how technology can totally transform the process for you.
00:01:14
Speaker
In our news recap, we'll cover growing concerns from various ASC leaders, a new hospital price transparency bill, which if passed will impact ASCs, Walmart's new pharmacy delivery ah initiative, and of course, end the new segment with a positive story about three nurses who went viral for their new CPR training technique. Hope everyone enjoys the episode and here's what's going on this week in surgery centers.
00:01:43
Speaker
Hi, Marie. Welcome to the show. Thank you. Thanks for having me. So you were actually on the podcast back in February of 2023. And I don't know if you know this, but that episode we did back then on KPIs is actually in our top 10 most listened to episodes of all time. Wow.
00:02:04
Speaker
ah Yes, I am super excited to have you back on so you could share some more wisdom with our listeners. But before we jump in, can you please share a little bit about yourself and your ASC experience?
Revenue Cycle Management & Strategies
00:02:16
Speaker
Yeah, so I am the admin for a large surgery center here in Walnut Creek, California. I run a 6OR1 procedure room ortho spine center. We are just got voted and number one ASC in California and just today received another leapfrog accredited accolade from them, which is a national award for top ASC.
00:02:43
Speaker
So yeah, we're pretty excited. We're a great facility. I've been running facilities for 15 plus years and I have a lot of knowledge. It ah started off with a background in business office and moved to the admin role. Very cool.
00:03:00
Speaker
So you're the perfect candidate to help us close out our series on improving patient collection. So yeah start with, start at the top. Why is improving patient collection so crucial just to the overall health of a surgery center's revenue cycle? Improving patient collections is one of the important key components of effective revenue cycle management. Generally 20% of your revenue is through patient collections and most medical practices only collect 60% of this.
00:03:29
Speaker
So improving your patient collection should remain as your top priority in your financial plan to a healthier bottom line. So first and foremost, it is well known that most people will pay their most important bills first. For example, rent, mortgage, utilities, food, and even credit cards because they're afraid of outrageous interest charges. But when it comes to medical bills, there is an unspoken option of paying what you can.
00:03:58
Speaker
Generally, there's no recourse for not paying your bill in full when you receive it or really at all. So that's why upfront collections is important because the incentive is before surgery and not afterwards. To be successful in upfront collections, there are a few steps you can take, the biggest being collecting payments upfront. If your facility is not doing this already, you need to start today.
00:04:27
Speaker
Definitely, and as you mentioned, collecting these payments upfront can certainly be a challenge. What strategies can ASCs implement to make this process smoother and ensure patients are informed well in advance of their procedure? Yeah, so I think making sure you give patients enough ample notice is always a good idea, allowing them time to gather funds and not stress them out. Surgery is stressful enough.
00:04:55
Speaker
For example, do not call the night before and ask them to bring $1,000 in. If your insurance verifier is too bogged down and can't make the calls in a timely manner, um think about hiring a second person or arrange for more help in that department. The additional expense you incur will more than pay for itself. um Also, if patients have no cash, allow them to sign up with a third party finance company like Care Credit to to make payment plans.
Third-Party Financing Benefits
00:05:27
Speaker
Yeah, have you found that those third-party financing options such as Care Credit has helped to mitigate the financial risk? Yes, this really, yeah, it removes the risk off the surgery center books and puts it onto the finance company. Having a patient go through a third-party finance company also gives them a chance to pick longer payment terms than maybe what the center would be allowing.
00:05:54
Speaker
Additionally, it allows you the chance to know if they have the necessary discipline for you to extend credit to them. For example, if you suggest they apply for a third party finance company be because they can't afford or they can't pay their bill. And if they refuse right away, it's usually followed up with, oh, no, I have bad credit. Once this is revealed, you should be very cautious about offering a payment plan or rescheduling all together until they have more funds available. If all else fails, make it a big deal. So often when patients suggest they don't have money to pay their portion at time of service, suggest they reschedule their appointment, somehow will be important to them. And the 90% of the time they will find the money. Yeah, those are some excellent tips. What are some best practices for creating transparency around patient payment expectations and
00:06:50
Speaker
We see all this legislation now. How does this align with regulations such as the No Surprises Act? Yeah, so yeah, you always want to make sure what they owe is discussed and clear, so there's no confusion. If you're offering payment plans, be very clear on the terms. Consider offering discounts on early payoffs or penalties for late payments. Your phone discussion should always be followed up with an email or text reiterating your discussion.
00:07:19
Speaker
That way there's no disputes and it always makes sure this is done before surgery. So your patients can make informed decisions and you are compliant with the no surprise billing act.
Payment Methods & No Surprises Act
00:07:30
Speaker
um Bottom line, improving communications with patients will help you improve collections. Sure. And I find that many surgery centers struggle with providing convenient payment methods.
00:07:43
Speaker
Can you discuss the importance of offering multiple payment portals and how things like Apple Pay could help improve collection rates? Yeah, we live in such a convenient driven time that any sort of delay, for example, having to submit a check or picking up a phone call, picking up a phone to make a phone call on to make a payment is considered taboo in this day and time. One of the easiest things A business can do is to make sure your website is set up with a patient payment portal. You can also implement smartphone technology like Apple Pay. They conveniently forget their checkbook or they left their credit cards at home. they Most people now they have some kind of technology on their phone to pay through that. There's also technology that you can sign up that will send the patient a text message and they can pay directly on their phone.
00:08:38
Speaker
Anything that does not allow a patient an excuse to not pay will boost your collection rate. Sure. Yeah, we've actually found in the work that that we've done, I think it's about 30% of patients who have the option to pay online will pay something at the time that they receive that text invoice or whatever that communication is. and it just it to your point, could be so effective. I'd never carry cash, but I always have five credit cards ready to go. of cols soon yeah exactly ah Yeah, that's great advice. I actually was speaking with the surgery center recently and they were trying to improve their collections and I was asking them their current methods and they told me that they had a PayPal link on their website.
00:09:23
Speaker
And I was like, that's an an excellent start, yeah ah but we can iterate off of for that to go even further. So right it all helps. New technology is coming out every day. So if a patient cannot pay upfront or refuses a third party financing option, or maybe they don't get approved, how do you typically handle that situation? Yeah. You first look at the case and know your costs.
00:09:50
Speaker
it's Is the reimbursement sufficient enough to make money, even if you receive zero payment from the patient? If the answer is yes, then proceed with the case. if they're If the answer is no, then proceed with caution. I would definitely involve the physician or admin and ask them how they want to handle it, and you trust they have you because you trust that they have your center's best interests in mind. So I think just communication with your team is going to be the best way to handle that.
00:10:21
Speaker
Sure. And do you find that when you are having that communication with that team, are there just certain thresholds people are more comfortable with moving forward with the case? Yeah, it's really, yeah, how comfortable. I think also physician buy-in is going to be the most important thing too. How did your, because generally most physicians have ownership in a surgery center and they want to, they want the center to do well. So how strongly do they feel about the patient and how strongly do they feel about collections is really going to be your dividing factor too.
Community Building & Industry Challenges
00:10:55
Speaker
Sure. That makes sense. Yeah. All right, Marie, we do this every week with our guests. What is one thing our listeners can do this week to improve their surgery center? Informed. Make sure you're always have the latest news on information such as patient collections. Listen to podcasts like this one. Read articles. Make sure that you always are staying on top of everything
00:11:20
Speaker
I know it's a lot of information and it's the saying goes, how do you eat an elephant? You just one bite at a time. So yeah, that's my biggest takeaway from that. Yeah, I think that's great advice. I'm always a huge advocate of the state associations. Ask all these communities. Everyone is dealing, whatever issues you're struggling with, someone else is struggling as well or has already gotten through it. So building that community is huge.
00:11:47
Speaker
Thank you again for coming on for for all your great advice. Thank you. Thanks for having me.
00:11:55
Speaker
As always, it has been a busy week in healthcare, so let's jump right in. Becker's ASC asks six ASC leaders, what scares you for the future of ASCs and why? Here are a few of the common themes that were found in all their responses.
00:12:11
Speaker
The first common theme is declining reimbursements from Medicare and private payers, which aren't keeping pace with rising costs due to inflation, staffing shortages, and increased supply expenses. Leaders fear that without changes in CMS policies and more equitable payments, many ASCs will struggle to remain profitable, especially as hospitals expand their own outpatient services, creating more competition.
00:12:34
Speaker
Another shared concern is the growing regulatory and administrative burden, which diverts focus away from patient care. Staffing challenges also loom, particularly in the shortage of anesthesiologists, surgical techs, and nurses, which makes it difficult for ASCs to maintain operational efficiency and quality care.
00:12:54
Speaker
The overarching trend is that ASCs are being forced to do more with less, which could impact their long-term sustainability if reimbursement policies and resources resource availability don't improve.
00:13:06
Speaker
Now, I do not want to be all doom and gloom here. There are silver linings and solutions here for sure. First, make sure you join your state association and ASCA. These organizations provide excellent resources to help you solve a lot of these challenges and will connect you with your peers who are experiencing similar issues and working through them. Having that community around you is huge. Second, when I look through these issues at a glance,
00:13:33
Speaker
Leaning into data every step of the way can help a ton. When it comes to private payers, negotiate your contracts using proven data and outcomes. So go into your negotiations with as little to no motion as possible, but instead show your case volume by mix, your growth trends, clinical outcomes in comparison to other ASCs, HOPDs, or hospitals.
00:13:56
Speaker
Compare the cost per procedure at your ASC versus the cost in a hospital setting for similar procedures. ah Show your patient satisfaction surveying results, your low readmission rates, whatever you can. Without data, it's going to be extremely hard to get better rates.
00:14:11
Speaker
So going back through the trends and the concerns, that'll definitely help you hopefully with some of those reimbursement issues.
Legislative Updates & Pharmacy Innovations
00:14:19
Speaker
And then when it comes to regulatory and administrative burdens, it's mostly on the admin side, but we have options now where AI can help significantly, technology can help significantly. So don't just overlook that.
00:14:32
Speaker
And it's not only going to help with the administrative burden, but it's also going to help you feel the effects less of the staffing shortages you may currently be experiencing. So again, I don't want to oversimplify this. I know there are a lot of variables, but there also are solutions to get you started. And if you do need benchmarking data, HSC just released our 2024 State of the Industry report for ASCs. And it has 35 plus charts you can use to start setting the scene, starting to set the scene when it comes to benchmarking and the success that you're seeing. So I'll include a link in the episode notes so you can easily access it. All right, switching gears. There is a new hospital price transparency bill in Pennsylvania that if passed will impact certain ASCs.
00:15:19
Speaker
So SB1344 was introduced on October 18th, and it predominantly creates state-level hospital price transparency requirements based on existing federal requirements, but includes facility fee disclosure requirements as ah as well. So healthcare facilities, which is defined to include ASCs,
00:15:40
Speaker
that charge facility fees and are affiliated with or owned by a hospital will be required to disclose those fees to patients both at the time an appointment is scheduled and when medical services are rendered. The disclosure is required required to include information such as the dollar amount of the patient's potential financial liability for a facility fee and a statement that they may incur a greater financial liability at the facility than they would for treatment received on a hospital campus, which is interesting. I don't necessarily agree with that, but that is neither here nor there. Nothing is official yet, though, as Pennsylvania's legislative session is scheduled to end November 30th, meaning the bill may be an attempt to just gauge support for the issue ahead of a reintroduction in the 2025 to 2026 legislative session.
00:16:32
Speaker
Now I saw this news on Aska's website. So if you want more information, I'd had to ask his website so you can stay on top of any updates. If you're in Pennsylvania, definitely connect with the Pennsylvania State ASC Association. And of course I'll share updates on the podcast as well as they come out.
00:16:48
Speaker
This bill though is really just another reminder of the direction the industry continues to head in regarding price transparency. We are basically the only industry that provides a service where it's not required for the consumer to fully understand what they owe down to the penny.
00:17:05
Speaker
I always use the airplane analogy. So imagine you take a flight, but the airline gave you a rough estimate in advance. And then once you land, you're going to get bills from the flight attendant, the pilot, the baggage handlers. It's so bizarre when you think of it like that. And if that's how travel was actually billed, you would dread it and do anything you could to avoid it, even if it was in your best interest. So We are seeing legislation come through with the No Surprises Act and other bills at the state level, but it's just a best practice to tell patients what they owe before they have a procedure. And if you need help with that, we have a wonderful product called HSC Clarity that can help you generate those estimates, comply with all this new legislation popping up, and of course help you improve collections.
00:17:55
Speaker
Okay, so a few years ago, Walmart did a survey to its customers and found that 55% would like prescriptions included in their grocery deliveries and other online orders. Sounds like a dream. This was one of the top requests they received, so in an effort to meet that demand, just a few weeks ago, Walmart announced that it would be expanding same-day delivery to include prescription meds.
00:18:21
Speaker
Eventually, customers will be able to get prescriptions delivered within hours or as soon as 30 minutes. The option is currently available in six states, which are Arkansas, Missouri, New York, Nevada, South Carolina, and Wisconsin, with plans to expand to 49 states by the end of January. Now, the article did not say which state would not be included. If I had to go out on a limb, I would say I would guess Alaska, but don't hold me to that. I don't know for sure.
00:18:48
Speaker
So the plan is to expand to 49 states by the end of January, 2025, anticipating that they will be able to reach 86% of households in the country. And under this program, customers can include prescriptions, grocery items, or both for delivery. Walmart Plus members who pay a $98 annual fee will receive free pharmacy delivery, and non-Walmart Plus members will pay $9.95 for delivery, $9.95.
00:19:17
Speaker
So this comes at a very interesting time, which is why I wanted to share this article. So if we look at all these pharmacy giants, Walgreens said it will close 1,200 stores in the next three years. CVS confirmed plans to lay off 2,900 employees. Amazon confirmed hundreds of layoffs in their pharmacy and healthcare departments. And even Walmart is ending its telehealth services.
00:19:40
Speaker
So these conglomerates are definitely struggling to scale operations and be profitable in the healthcare care arena. So first, I just think it's super interesting as consumers, right? I love Walmart. I have one just a mile and a half from me. I'm going there tonight to pick up some things.
00:19:58
Speaker
I don't use them for my pharmacy though, but I would have loved to get my sinus infection meds delivered to me in an hour this week versus driving to CVS and waiting in the drives through for 30 minutes. Now, first world problems for sure, but delivery sounds lovely. But for surgery centers, this could be a really helpful option for patients who might not have the means to pick up their recovery medications themselves. So if you think about patients who might not have a car or can't drive or use public transportation, or maybe they don't have family nearby to help them out after they're discharged, you could recommend this Walmart delivery service to them, which could help to improve their recovery process and outcomes. So this new service just might be something you want to look into for yourselves, but also for your patients.
00:20:48
Speaker
And to end our new segment on a positive note, what if the song Stuck in Your Head All Summer Could Help Save a Life? So three labor and delivery nurses from Texas, ah Julie Watson, Nicole Curry, and Alyssa Gonzalez are showing how Sabrina Carpenter's Hit Please can guide CPR chest compression compressions.
00:21:10
Speaker
In a viral TikTok video, the nurses use the song's rhythm to demonstrate the correct tempo for CPR during their resuscitation quality improvement training. The American Heart Association even backed their discovery, promoting it as a great two tool for hands-only CPR. This fun and innovative approach highlights how using familiar music can make life-saving skills easier to learn and apply in emergencies.
00:21:36
Speaker
songs like Beyonce's Crazy in Love and BG's Stayin' Alive also share the right tempo. So if you ever find yourself in a situation where you need to perform CPR, these are just a few songs you can use to one, stay focused and as calm as possible and to to perform CPR correctly to hopefully save a life.
00:21:57
Speaker
And that officially wraps up this week's podcast. Thank you as always for spending a few minutes of your week with us. Make sure to subscribe or leave a review on whichever platform you're listening from. I hope you have a great day and we will see you again next week.