8 Points on Improving Collections of Outstanding Balances from Patients

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NorthShore University HealthSystem, based in Evanston, Ill., launched an initiative seven months ago to improve collections of outstanding balances from patients who come in for more services. Deborah Kirkorsky, vice president of business services at NorthShore, provides some insights on the initiative.

1. Harder than collecting copays. NorthShore trained front-office staff 10-12 years ago to collect the copays and raised the copay collection rate to 95 percent. But collecting outstanding valances will be more difficult. The current rate for collecting on outstanding balances is 5-6 percent and the initiative's goal is to raise that rate to 10 percent.

2. Provide formal training. From Dec. 2009 to Jan. 2010, NorthShore provided front office staff in-depth training on collecting outstanding balances. Training involved a 40-page training document with suggested dialog such as, "How would you like to pay that today?" Interactive workshops involved role-playing with participants playing patients and staff.

3. Cover typical scenarios.
The training document included 10 common scenarios. For example, if the patient says, "I didn't get a bill for that," the staffer can usually provide information on whether the bill was sent. The billing department can even fax a statement to the office for the patient to review. And if the patient says, "This information is not correct," the staff member can offer to put the patient on the phone with the billing office.

4. Don’t push too hard. Staff are instructed not to persist too longer than a few minutes. "We continue if we think we have the potential for collecting it," Ms. Kirkorsky says. "Otherwise, we stop."

5. Observe legal limits.
The HIPAA privacy law forbids staff from asking about the bill of a spouse or a family member, even though they have the same health insurance policy.

6. A win-win situation for patients. Staff members explain that resolving the issue prevents the bill from going to a collections agency. The process also can identify patients who need financial assistance.

7. Hold contests for staff. Information on each office's collection rate is posted for employees on the NorthShore intranet site every two weeks. NorthShore holds contests for staff with the best and the most improved collection rates.

8. Provide help for struggling staff. Staff who have difficulty asking about outstanding bills get extra help from trainers or successful peers. These mentors can sit with the protégés and help them through the process.

Learn more about NorthShore University HealthSystem.

Read more on hospital finances:

-Study: Rising Operating Costs Top List of Practice Challenges for 2010

-Four Major Challenges in the Hospital Revenue Cycle

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