There’s a stigma around Point of Service collections. Patients don’t want to pay. They won’t return for service. Physician satisfaction scores will go down. While these are normal concerns for providers, there are ways of effectively collecting patient responsibility at the time of service while actually increasing patient and provider satisfaction.
As patients push for stronger pricing transparency and payors move more out-of-pocket costs to the patient, it is critical that providers implement and practice a strong Point of Service collections program.
With these three simple steps, you can ease the pain points of implementing or enhancing an effective Point of Service collections program:
It is critical for senior leadership to support Point of Service collections within the organization. If Point of Service collections is new or minimal, executive leaders can voice their support through setting expectations and communicating with clinical and department leaders. This may include ancillary, nursing, physician, administrative and support department leaders.
It is not uncommon for other departments to intervene during Point of Service collection attempts by instructing patients not to pay or to wait for a bill. Often they may think they are helping the patients, but ultimately this causes disruption and can leave the patient frustrated later once the statement is received.
By communicating in advance to departments, leaders and even physician practices, senior leaders set the tone for collections expectations and can explain the why behind this effort. While communicating in person is ideal, utilizing e-mail, your organizational newsletter, webinars, video or conference calls can help spread the word through a variety of channels.
When discussing and presenting patient responsibility, approach it from a mindset of educating and assisting the patient. While many providers may be hesitant initially to review large out-of-pocket amounts with patients, surprising them with a large bill after service may have the opposite desired effect. By explaining specific benefit coverage and payment estimates, you can increase patient satisfaction by mitigating their concerns around the unknown.
To educate the patient on their estimated liability, complete the following steps.
- Conduct a comprehensive review of insurance benefits well beyond deductible and co-pay amounts
- Prepare and present an estimate whether via letter, text, e-mail or online service
- Communicate well in advance for scheduled services to allow the patient time to prepare
- Include discussion and review around any outstanding prior balances
Assist qualified patients with securing applicable coverage through Medicaid, COBRA or a variety of other potential assistance programs. Provide patients various options whether it is financing, charity assistance, prompt pay discounts/flat rates, co-pay assistance or payment plans. Dedicate time to assist patients through this process which can often be overwhelming and confusing. For applicable services, consider bundled pricing and payment discussions (e.g., surgical physician office visits with the facility and anesthesia pricing).
Point of Service Collections and EMTALA
It is important to note that providers can still maintain a strong Point of Service collections program while abiding by the Emergency Medical Treatment and Labor Act (EMTALA). By coordinating with the clinical departments and physicians, Patient Access can be notified once the Medical Screening Exam is complete to perform bedside registration including the review and collection of estimated amounts due. Your organization may prefer a discharge process instead of bedside registration, which can still be inclusive of Point of Service collections. It is advisable to coordinate with your local Compliance leader to determine your organization’s interpretation and processes around EMTALA.
The Bottom Line – You Can Take the Pain Out of Point of Service Collections
While there are many options for implementing or enhancing Point of Service collections within your organization, by making these three components foundational to your efforts, you will help alleviate several pain points and build a robust program.
By using these foundational concepts, Ensemble Health Partners has helped partners achieve up to 300% of prior year collections with no disruption to volumes or patient satisfaction.
Author: Emily Jones
Emily Jones is the SVP of Patient Access Services at Ensemble Health Partners, where she believes in practicing servant leadership by providing education, structure, internal growth and proactive support to her teams. She leads through influence and collaboration, coordinating closely with back-end teams to identify issues and trends that can be mitigated within Patient Access. As an operational leader, she brings 17 years of Revenue Cycle experience to Ensemble, including 5 years in the physician setting (supporting 20+ practices) and 12 years within the acute care/facility setting. She has managed Patient Access and Pre-Access functions for 14 years, including in her current role for multiple clients.