1. Communicate payment plans early and often. Melody Winter-Jabeck, administrator at Ravine Way Surgery Center in Glenview, Ill., says if patients find they are unable to pay the rising cost of deductibles for surgery, ASCs should communicate early and often payment plan options or some other flexible payment arrangement to patients. Not offering up alternative payment methods or plans from the start can push back payment collection by a significant number of days, directly affecting the ASC’s A/R. “We are currently looking into setting up payment plans or some sort of financing in cases where there is a financial issue for the patients,” Ms. Winter-Jabeck says. “The trend we’re seeing is that more and more of the financial responsibility is being put on the patient with higher deductibles and out-of-pocket fees.”
2. Have a scheduler follow patients who haven’t paid in the past. With an increase in high deductible plans and general economic challenges, more patients are having their bills sent to collections, and this will often lead an ASC to eventually write-off unpaid co-pays and deductibles. Considering that patients can be repeat customers to an ASC, some non-paying patients will eventually return. “There’s nothing worse than having someone you did a procedure for never pay, and now you’re seeing them again and you’re likely just going to take another hit,” says Brice Voithofer, vice president of ASC and anesthesia services for AdvantEdge Healthcare Solutions.
The solution: Develop a policy and procedure followed by schedulers where the scheduler looks on a list or a note within your billing system during the scheduling process, and identifies if a patient previously had a balance the ASC wrote off or is currently in the active collections process. “Then have the [scheduler] educate patients that they’re not having another procedure unless they pay the outstanding balance, and remember to avoid any issues which could be classified as abandonment,” says Mr. Voithofer. “Putting this tool in place is easy and could generate significant revenues — it can be a few hundred dollars written off with each account, and that adds up very quickly.”
3. Use eligibility software to screen patients’ coverage. One of the ways practices most frequently lose money is by seeing patients who are not eligible to receive coverage on their treatment, Dave Wold, CEO of Healthcare Information Services. Eligibility software allows physicians to check the availability of the patient’s coverage before he or she comes into the office. The software will show the patient’s coverage status and whether the patient has unmet deductibles. If the patient does not meet coverage requirements, the practice has time to speak with the patient before the appointment and make prior payment arrangements.
4. Use a third-party payment plan for patients who can’t pay up front. Not every patient will be able to pay for an expensive procedure up front, and your facility shouldn’t have to turn away those patients, says Rob Morris, vice president of marketing and new business development for GE Capital’s CareCredit. In that case, you can use a third-party payment plan through companies like Chase or GE’s CareCredit that will approve or deny patients based on their credit rating. If a patient is approved by the payment plan, he or she can make regular payments for the procedure, and any failure to pay is generally absorbed by the payment plan.
These payment plans generally function like dedicated healthcare credit cards that can only be used for healthcare charges. A patient can apply at the center by entering several pieces of personal information, and the payment plan company automatically approves or declines the patient based on how likely or able they are to pay. The third-party payment plan means a third-party company assesses a patient’s ability to pay and absorbs the loss, creating less financial hassle for your center.
Mr. Morris says an ASC should only resort to its last option — billing the patient after the procedure — if the patient arrives on the day of surgery and cannot pay and a day-of-service cancellation would create animosity between the surgeon and the center. In that case, ASCs should research how to receive the highest possible payment from post-discharge collections.
5. Have someone to guide patients through the out-of-network process. The Virginia Spine Institute hires patient coordinators and insurance liaisons to help patients navigate out-of-network care, says Thomas Schuler, MD, a spine surgeon, founded the Virginia Spine Institute. Insurance companies can make it difficult for patients to receive out-of-network care and the experts guide the patient through the steps he or she needs to take. “We work to create a system that helps the patients understand and be more successful in navigating the very confusing out-of-network experience,” says Dr. Schuler.
