Case Study Analysis: The California Sutter Health Approach
The self-pay population is not as simple as it once was. Gone are the days when accounts in this segment automatically meant "indigent" or "charity care." Today, many types of consumers are self-pay patients, including insured patients who are paying balances due on their hospital bills after insurance. Unfortunately, most hospital collection processes continue to treat all self-pay patients the same. In doing so, hospitals miss opportunities to collect from willing individuals or age accounts unnecessarily.
One indicator that your self-pay collections need attention is if you are mailing the same letter to all self-pay patients, regardless of their balance or ability to pay. This process may be easy, but certainly it isn't effective or in the best interest of the organization (://www.allbusiness.com).
The Sutter Health Approach
Sutter Health, one of Northern California's largest providers, is committed to giving its PFS staff on both the front and back ends the tools they need to improve patient collections and thus the system's bottom line. Having started in 2006 with the patient account representatives, collectors, and other members of the central business office of its Sacramento/Sierra region, the health system is working its way forward to the registration staff, ultimately aiming to transfer many of the back-end functions to the front end and make point-of-service collection the norm.
Empowering PFS Staff
Sutter's strategy for increasing collections and reducing A/R days focused on empowering individual PFS staff members to assume responsibility for each account they deal with. In effect, each person in the CBO owns his or her own business, complete with a customized dashboard to track progress in meeting individual and team targets.
Sutter's system is designed to support the existing PFS and registration staff without the need to hire a more formally educated staff or to increase wages beyond the current average of $10 to $20 an hour. The system does, however, require that staff receive comprehensive training. The focus of the training differs with different staff areas.
Training and Technology
One simple, low-cost method involves sitting down with your registrars and explaining the problem. Chances are good that, if they understood the issues facing the collections department, they would want to help. Offering monetary rewards for behavior that helps reduce bad debt can be very effective, especially in small and mid size organizations with receptive employees.
Success Starts at Registration
The most successful hospitals focus first on using technology to screen their accounts at registration, then use established policies and procedures to guide their self-pay patient interactions. The following steps help organizations classify their self-pay accounts to receive the highest payment with the lowest account aging.
Step one: Screen for government program eligibility. Patients may not be aware of state and/or federally funded programs designed to assist them. As a service to patients, hospitals should assist patients in identifying appropriate programs that match their financial status. This step not only helps patients minimize billing concerns, but also offers your organization some level of payment that wouldn't ...