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Erica Palmer – Improving Patient Collections: Post-Date of Service  image

Erica Palmer – Improving Patient Collections: Post-Date of Service

S1 E90 · This Week in Surgery Centers
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Welcome back to our three-part series on Improving Patient Collections! In our last episode, we were joined by Sayword Hill from Constitution, who shared expert insights on mastering eligibility. This week, while we had originally planned to bring you another guest to dive into post-date of service (DOS) collections, plans shifted due to Hurricane Milton. So, it's just me, Erica Palmer, taking the mic solo to share actionable tips for boosting patient collections after your patients are discharged.

This episode couldn’t have come at a better time! HST recently released our State of the Industry Report, packed with valuable data, including insights on outstanding post-DOS patient bills. I’ll be weaving that data into today's episode as I break down key strategies to improve your collections process and maximize your revenue.

Resources Mentioned:

HST’s 2024 State of the Industry Report

Brought to you by HST Pathways.

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Transcript

Episode Introduction

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.

Series Continuation: Patient Collections Update

00:00:27
Speaker
Hi, everyone. Here's what you can expect on today's episode. We are in the middle of our three-part series on improving patient collections. Last week, we had Sayward Hill on, who talked through how to master eligibility. Today, we were supposed to have a guest on to cover tips for post-data service collections, but unfortunately, due to Hurricane Milton, we weren't able to

Tips for Post-Service Collections

00:00:49
Speaker
record. You are stuck with me. I'm going to fill in and still share a handful of post-data service tips that will help you boost patient collections after your patients are discharged. And it is great timing because HST just released our state of the industry report last month. And we shared a ton of data points, a few of which covered outstanding patient bills post data service. So I'll weave in that data while going through the tips to help add context. Hope everyone enjoys the episode and here's what's going on this week in surgery centers.
00:01:25
Speaker
All right, let's get into post-data service collections at a surgery center.

Early Follow-ups and Communication

00:01:30
Speaker
So after patients are discharged from your facility, it can be really tricky to continue to collect outstanding balances. It is so tricky that some facilities are actually moving towards policies where where they will not proceed with a procedure until the patient's responsibility is paid in full. So let's chat through five tips for improving post-data service collections so that you can get paid for the services you're providing.
00:01:54
Speaker
Now, this first tip is more of just a reminder of best practice, but it's to follow up early and regularly. So one of the most effective ways to improve post-data service collections is to follow up with patients promptly after surgery. Now, this is absolutely a delicate balance because you also need to check on their recovery, which is the primary concern. So perhaps your policies state that within 24 hours, the doctor or the nurses or nurse is going to follow up.
00:02:22
Speaker
But reaching out maybe a week after the procedure allows you to do both. You can check on their recovery again, and if things are going well and it's a positive positive recovery and conversation, then you can take the opportunity to gently remind them about any outstanding balance. But if they are experiencing any issues during their recovery, then it's maybe not the time to mention their bill, and perhaps that call comes a few days later.
00:02:48
Speaker
And I am usually all about the automated texts and emails, which we'll get into. But in this case, patients appreciate a personal touch, so a quick call would could really go a long way.

Automated Payment Reminders

00:03:00
Speaker
The second tip after that initial phone call is to leverage automated payment reminders. So automation tools are invaluable for post-data service collections.
00:03:10
Speaker
By setting up automated emails and texts, you can send reminders without placing additional strain on your staff. These reminders should include links to make payments online, making it super easy and convenient for patients to settle the their bills. Automated systems can also be set up to trigger different messaging depending on how overdue a payment is. Maybe we have the friendly reminders early on to more urgent notifications as time progresses.
00:03:37
Speaker
And this will also help you maintain consistency, which is key in your follow up process. So when you're setting up these automated reminders, you can schedule them to go out 15, 30, 45, 60 days after the data service. And you can also test to see what days and intervals are most effective for you. I spoke with one surgery center who saw a spike in payments when they sent a text reminder on the third Friday of the month. So if you think about it, most people get paid every other Friday, right? So that first paycheck, we all know that's going towards your regular bills, the mortgage, rent, car, insurance, utilities.
00:04:12
Speaker
The list is never ending. But that second paycheck is usually extra income to some degree, so people feel less overwhelmed or more willing to pay. So it's things like that that you can test to see if it makes an impact for you. And again, that can all be automated.
00:04:28
Speaker
Also another reason why offering text or email is so important in the work that we've done, we found that 30% of patients contacted via text or email will typically pay electronically. So by sending patients a clear snapshot of their costs and giving them a button right on the invoice or whatever tool you're using, you can easily get paid faster and drive payments.

Flexible Payment Plans and Counseling

00:04:53
Speaker
The third tip is to offer flexible payment options and counseling. So post-data service, some patients may find themselves struggling with their financial responsibility. So it's not that they don't want to pay, maybe they just aren't in a financial situation where they can give over a big lump sum. So offering flexible payment plans allows patients to settle their balances over time rather than requiring that full payment all at once.
00:05:18
Speaker
And by breaking the total into smaller, more manageable amounts, you will reduce the likelihood of nonpayment. I always think about, let's say a patient owes a thousand dollars and you just keep sending them this thousand dollar bill. It can feel so overwhelming. They'll probably just continue to ignore it if it's not a sum of money that they just have laying around. But if you send them, put them on a payment plan for a hundred dollars over the course of 10 months, now that feels much more reasonable.
00:05:45
Speaker
fits into their lifestyle, and even though it takes longer, you still get the money that is owed to you. So it's definitely worth it. The key though, again, is to make it easy for patients to opt into these plans. And going back to the previous tip, make it automated. You can set up plans that have direct withdrawals, so it does not require any manual steps from your side or the patient's side.
00:06:08
Speaker
ah You can also offer incentives to patients who do set up the direct withdrawal. So maybe a two to 5% off their total bill or whatever you're able to offer, just continue to incentivize them. Also having someone to counsel these patients is key. So make sure your staff is trained to explain the options to them clearly. And by having flexible payment plans or often offering various levels of financial counseling,
00:06:33
Speaker
You'll just demonstrate that your ASC is willing to work with them to resolve their financial obligations, which can reduce the risk of sending accounts to collections, while of course improving patient satisfaction as well. And in my prior days, I used to work at a ah very popular patient satisfaction surveying company.
00:06:51
Speaker
and The financial questions were always most, if a patient did have an issue at a surgery center, it was mostly related to just not understanding the financial obligations and what they owed and having to get refunds and that part kind of being a mess. So locking in your financial processes, will also see an increase you'll also see an increase on your patient satisfaction surveying scores.
00:07:14
Speaker
And don't forget, you can also leverage third party RCM companies too. There are so many out there that are dedicated to the ASC space that can help you out. The fourth tip is to monitor and prioritize high value accounts.

Prioritizing High-Value Accounts

00:07:30
Speaker
So not all overdue accounts carry the same financial weight, so it's important to focus extra effort on those high value accounts.
00:07:38
Speaker
that represent significant outstanding balances. These larger accounts can have a considerable impact on your ASC's overall revenue and cashflow, so they should receive additional attention through targeted follow-ups and personalized outreach. You're going to have patients that might owe you $4,000. You're going to have patients who might owe you $100. They're not all created equal.
00:08:00
Speaker
And again, this should not be a manual process for your team. Your billing software should be able to flag these high-value accounts early in the process, which will allow your team to take a more proactive approach. And prioritizing these accounts could mean setting up specific workflows, such as more frequent reminders, dedicated follow-up calls, or even special payment plans. All right, your fifth and final tip is to track payment interactions with transparency.

Tracking Interactions and Resolving Disputes

00:08:29
Speaker
So one common issue in post-data service collections is when patients claim they never received the bill or payment notice. This can be addressed by implementing tracking tools that monitor when a patient views their estimate or invoice. Using software, that shows the date and time a patient ah viewed their estimate will provide clear evidence if a dispute arises. Hopefully it never comes to that, but this visibility allows your team to address claims of non-receipt with transparency and professionalism. Additionally, if you need to send a patient's account to collection,
00:09:04
Speaker
Having a detailed communication log that tracks every touch point, whether phone, email, or mail, or text will help the patient understand why sending them to collections is the only next step that that you have left. All right, so let's talk about the data regarding post data service collections.

Billing Speed and Cashflow Impact

00:09:24
Speaker
So HSC just released our state of the industry report and we pulled data from 590 clients who gave us permission to do so. And those centers span across 47 states and represent nearly 3 million patient visits. Our data analysts determined that on average, ASCs are taking five days to bill after the data service. Taking five days to bill.
00:09:48
Speaker
does directly impact cashflow and revenue cycle efficiency. Obviously, the longer it takes to submit claims, the longer it takes to receive payment. So reducing the days to bill means quicker payment turnaround for you. The specialty with the longest turnaround time is podiatry, averaging 7.6 days And then the specialty with the quickest turnaround time is dental averaging 3.1 days. Now, all of the graphs in our state of the industry report cover the top 12 specialties. So if you want to see where your specialty falls, I'll include the link to the report in the episode notes. It's also on HST's website under the resources tab.
00:10:26
Speaker
So I do highly recommend checking it out, especially if you want to get into see where your specialty falls. And one thing that was really cool to see when looking at the 2023 numbers compared to 2024, one major win is that every specialty decreased the average number of days it takes them to bill post data service, which is hopefully a trend we'll continue to see hold up in next year's report too.
00:10:49
Speaker
And if you're looking to lower your days to bill, I would recommend developing standardized templates for procedures. So by creating procedure specific templates, staff can quickly fill in the necessary info without missing key details. You definitely want to track incomplete charts. So incomplete charts are one of the biggest delays in the billing process. So you can implement a system to track those charts charts and flag them for immediate action.
00:11:14
Speaker
Again, you're automating your billing workflow. So ideally your practice management or billing system automates key steps for you in terms of verifying codes, generating claims and sending them to payers. You also want to cross train staff. So you want to ensure that the billing process can continue smoothly, even if certain team members are unavailable. And then again, for ASC struggling to keep up with their billing outsourcing, RCM support could be a great solution.

Managing Accounts and Reducing Receivables

00:11:42
Speaker
Now, if we take a look at outstanding patient bills, we do see some interesting trends. Here we're looking at this direct correlation between number of days post-data service versus number ah of days a patient account goes unworked, meaning there's no activity to try to collect. And we found that on average, cases that are one to 90 days old are worked monthly. Cases that are 90 to 150 days old are worked every two months.
00:12:10
Speaker
And then cases that are 150 plus days old are worked to every two and a half months. And when patient bills go unworked post-data service, it just significantly delays that cashflow and increases the risk of those accounts becoming delinquent. A lot of these tips we covered earlier, but just a reminder prioritize those high value accounts, leverage automation, lean into flexible payment options, incorporate early invention intervention with phone calls and outsource if you need to.
00:12:39
Speaker
And if we take it one step further, we see that 70% of AR is greater than 90 days old. And so having 70% of AR over 90 days old could be a serious issue. It impacts cashflow again, reduces financial stability, increases likelihood of bad debt.
00:12:56
Speaker
And this shouldn't be any surprise to any of you, but the longer balances remain unpaid, the harder they become to collect. So a lot of the tips to mitigate this one I've listed already, but I would recommend breaking down your AR into 30, 60 and 90 day chunks. So you're working them in kind of these manageable groups, prioritize accounts and that are in the earlier stages of aging. So maybe one to 60 days, so you can tackle issues ASAP.
00:13:23
Speaker
and just use RCM software as much as you possibly can to help. So there you have it, a bunch of tips and data to help you improve patient collections post data service. Next week, I'll be joined by Marie Yarbrough, who is the administrator at Sequoia Surgical Pavilion to finish out our series on improving patient collections. So thanks for bearing with me through this solo episode 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.