This document discusses strategies for improving patient payment collections. It identifies six key areas for improvement: adding more payment options, enhancing early-stage collections, improving point-of-service collections, better managing the uninsured, updating billing statements, and enhancing staff competency. The document provides examples of best practices within each area, such as offering payment plans, propensity scoring to identify ability to pay, automated charity screening, and prompt-pay discounts on statements. The overall goal is to reduce uncompensated care and improve the patient payment and experience.

1. POS
Collections
Growing
Patient
Liability
Uber-Up Your
Patient Payment
Liability Strategies
Patient
Advocacy
Uncompensated
Care
Sponsored by

2. Presenter
Phil C. Solomon
Vice President of Global Services at
MiraMed
Phil serves as the Vice President of Global
Services for MiraMed, a revenue cycle
outsourcing company and is the publisher of
Revenue Cycle News. He has over 25 years
experience consulting on a broad range of
healthcare initiatives for revenue cycle
performance improvement by developing
executable strategies for revenue
enhancement, expense reduction, and
clinical transformation.
phil.solomon@miramedgs.com
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3. Polls & Survey
3
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2
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4. 4
Healthcare trends 2016
Patient payment liability facts
Why be concerned about patient liability?
Patient collection strategies
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2
3
4
Agenda
4

5. 5
Pre-visit | Post-schedule strategies
Point of service collection improvement
Patient billing statement psychology
Early stage collection improvement
Bad debt collection benchmarking
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2
3
4
5
Collection work flow best practices6
Learning Objectives
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6. Uber-Up Healthcare
B
Use Drivers
Own Cars
Smart Phone App
Prices Lower Than Taxi’s
Surge
Pricing
Business
Model
Innovation
Cashless Ride
Uber-Kids and Seniors
6

7. Healthcare Trends 2016
$3.2 Trillion | Share of GDP 18%
2014 Spending Grew 5.3%
U.S. Census Bureau
Courtesy of A. Lawrence Berry funds, PR1973.0467/19.

8. Healthcare Trends 2016
ICD-10
AccountableCareAct
readmission
penalty
8

9.  B2B
 B2C
 Big Box healthcare
 Concierge medicine
Healthcare Trends 2016
9
New Financial & Delivery
System
$40 per
consultation

10. 10
Patient Payment Liability
Not met deductibles
High copays or coinsurance
Lack insurance coverage
Non-covered services
Exhausted benefits
Who
are
they?

11. Patient Payment Liability
Patient Responsibility Buckets
11
True
Self-pay
Under
Insured
Balance
After
Insurance

12. Polling Question
12

13. Liabilities/pure self-pay patients
growing 19% year
BAI growing at 30% per year
Patient Payment Liability
TPR = $700 billion
McKinsey Quarterly: The Next Wave of Change for US Healthcare Payments
13

14. Patient Payment Liability
2104
$46 Billion
14

15. Patient Payment Liability
15
The Exchange Effect
 50% higher average balances
 55% higher average balance due
 16% lower recovery rate
 25% higher defaulted rate
 10% higher final notices
2014 – 2015 HCA Study

16. Patient Payment Liability
National Health Expenditure Projections 2012–2022, CMS
By 2019
$200
Billion written-off
30% Annual
bad debt growth
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17. 17
Why Be Concerned?
McKinsey Quarterly, May 2015
Americans Living
paycheck-to-paycheck

18. Bureau of Labor Statistics’ 2012 Consumer Expenditure Survey
Why Be Concerned?
18
>$40K = $0
To $49K = $1,508
To $69K = $3,253

19. Guaranteed Healthcare
…
63% can’t pay:
$500 car repair
$1,000 ER visit

20. Patient Collections
PATIENT EDUCATION
 Provide A-Z guidance through the process
 Train patients - online tools
 Patient’s understanding balance due
 Collection policies
 Confirm third party coverage
 Restate clinical preparation for encounter
 Give directions and answer questions
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21. Patient Collections
PRE-VISIT | POST-SCHEDULE ACTIONS
Complete mini registration - On-line, mobile or phone
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Complete more developed registration
Verify payer data
Reminder call – not a collection call
Verify benefit design
Collect outstanding balances
Discuss out of pocket amount due
72-hours
prior

22. Patient Collections
POINT OF SERVICE ACTIONS
 Train staff to ask, follow payment collection protocol
 Leverage patient obligation tools
 Fee estimation – real time eligibility
 Predict propensity & ability to pay
 Prompt-pay/self-pay discounts
 Payment plans with ACH - credit cards - CCOF
 Loans – commercial & personal
 Pay Cobra
Remember 501r
22

23. Polling Question
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24. Institute for Health Care Revenue Cycle Research - A Division of Zimmerman, LLC. National Pledge to Reform Uncompensated Care Reform Underway: Adopting Best Practices to Reduce
Uncompensated Care and Improve the Patient Experience. a special supplement to PATIENT PAYMENT BLUEPRINT™
Patient Collections
POS
24

25. Patient Collections
STATEMENT BEST PRACTICES
Numerous design strategies
 Patients want various styles
 Offer an opt-out for
e-Statement discount
 Use a call to action highlighting
the amount to be paid
 Communicate payment options
(phone/email/online, etc.)
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26. Patient Collections
 e-Statements
 Prompt-pay discount
 1st bill 20%
 2nd bill 10%
 Last bill 5%
 Incentivized to pay
earlier
 Compress payment cycle
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Pay Now
and
Save

27. Patient Collections
EARLY STAGE BEST PRACTICES
 Loan programs - recourse
 Early-out outsourcing programs
 Propensity | ability or pay scoring
 Automated charity qualification
 Score adjusted internal and external work flows
 Pre-collection letter series
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28. Patient Collections
BAD DEBT BEST PRACTICES
 Analyze agency fees by net return
 120 to 180 day – close inventory control
 Portfolio assignment split by scoring - not alpha
 Litigation | property liens
 501r handling charity cases
 Secondary collection agencies
 Debt buying/asset selling
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29. Polling Question
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30. Patient Collections
 3-5 statements
 1-3 letters
 1-2 phone calls
 9-12+ months placed
to bad debt
Traditional
 1 statement
 1 letter to > collection
 0 phone calls (various with
dialer)
 To early-out vendor
 3-6 months placed to bad
debt
 Bad debt purchase
Best Practice
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31. 6 Areas of Improvement
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Add
Payment
Options
Improve
Early-stage
Bad debt
Improve
POS
Collections
Manage
The
Uninsured
Update
Statements
Enhance
Staff
Competency

32. Insurance
Exchanges
IRS
501r High
Deductible
Plans
THANK YOU
phil.solomon@miramedgs.com
Cell: 404-849-8065
POS
Collections
Bad Debt
www.miramedgs.com