1. 33060_PatientAccess_WesternRegional
PAYMENT NAVIGATION COMPASS
Western Regional Healthcare*
163 Beds | Western United States
Located in the western United States, Western Regional caters to seasonal visitors and a large
local under-insured and self-pay population. Due to this patient mix, revenue cycle leaders
identified the need to act early to prevent the loss of dollars downstream in the billing process for
all self-pay patients.
CHALLENGE
How do we build a patient-centered
collections process?
Additional revenue over baseline
collected at POS in 2015
$1.12M
Value of charity care
in FY 2016
Reduced self-pay;
Bad debt over two years
$8.1M 40%
Results
Self-Pay Bad Debt Dollars by Quarter
2014–2016
Collection Dollars
FY 2016
RESULTS
36.6%
35.4%
Two-year increase in
presumptive charity
write-offs
Year-over-year increase
in patient payments with
prompt-pay discount
Q1
'14
Q3
'14
Q1
'15
Q3
'15
Q1
'16
Q3
'16
Mar May Jul Sep Nov Jan
Ski Season
End
Summer
High
Ski Season
Start
* Western Regional Medical Center is a pseudonym for a member hospital.
PROCESS
Patient Eligibility
and Estimate Data
Western worked with their Dedicated Advisor to build a pre-registration room where scheduling
information, which is integrated with PayNav and updated in real time, is displayed on a large screen.
Patients speak to representatives who work accounts, confirm eligibility, and provide estimates.
Patient Financial
Data Empowers
Financial Counselor
Front-office counselors review scheduled patients’ financial history to evaluate how often their accounts
have gone to bad debt or been paid off. Additionally they check patients’ federal poverty level. With
this data, the counselor decides how to assist the patient, including locating coverage or providing an
application for charity care.
Charity Policy
Allows for Billing
Office Write-Offs
In the billing office, representatives attempt to complete patient charity applications by reaching out to
guarantors for confirming documentation. Unresponsive patients with balances under $2,000 can be
written off as charity should they qualify using Self-Pay Compass data.
SOLUTION
Patient Dollars
a Risky, Growing
Share of Payer Mix
With their unique patient mix, Western needed to meet patients where they were. Rural land owners
and foreign visitors could be tricky to track down once they left the facility. Contacting patients
for financial conversations at home in advance or at the point of service allows for more open
conversations around payment options and provides a better picture of each patient situation.
Pre-registration BillingPoint of Service Charity
Patients contacted for eligibility and
estimate information with Payment
Navigation Compass (PayNav)
Scheduled patients
screened for financial aid
using Self-Pay Compass
Patients can choose to pay
via phone or at POS with
prompt-pay discount
Patients are enrolled in coverage or
provided charity application in line
with financial assistance policy
For patients with balance under $2K,
presumptive charity can be applied
using Self-Pay Compass data
Patients contacted to confirm
financial position; qualifying
patients receive financial aid