how to use naham’s accesskeys best practices to increase ... · february 22, 2017 10 am pacific /...

February 22, 2017 10 AM Pacific / 12 PM Central / 1 PM Eastern

How to Use NAHAM’s AccessKeys® and

Best Practices to Increase POS Collections

Today’s Speakers

Paul Shorrosh AccuReg CEO NAHAM Industry Standards Committee Chair NAHAM Board of Directors Member

Terry Kile Regional Director Litmos Healthcare

Today’s Agenda

•  NAHAM AccessKeys®

•  NAHAM POSC Best Practices •  Common Assumptions About POS Collections •  Better Patient Communications Skills •  Case Study: Park Ridge Health •  POS Collections Technology Solutions •  The Financial Impact of POS Collections

NAHAM AccessKeys®

Why are POS Collections Important?

•  70% chance of collecting at point of service - 30% after discharge1

•  Many patients may actually be willing to pay when they need the service

•  Reduce the cost of billing •  Reduce bad debt •  Correctly identify charity patients •  Accelerate cash flow for financial viability

PointofServiceCollec/onChance

A3erDischargeCollec/onChance

1AcademyforHealthcareRevenue,2014

NAHAM Definition of POS Collections

•  Any and all collections posted by Patient Access prior to and including discharge date.

•  This might include: •  Collections from self-pays •  Collections from insured patients (copay/deductible/co-ins) •  Initial payments collected for approved payment plans •  Prior balances and bad debt accounts

What are the NAHAM AccessKeys® ?

NAHAM’s Industry Standards Committee •  Comprised of patient access volunteer

professionals •  Have spent several years compiling this

outstanding resource •  Allows hospitals to compare their scores

against industry benchmarks •  Measures outcomes and not merely

activities

•  Industry standard key performance indicators (KPIs)

•  Designed by NAHAM for Patient Access Managers

•  34 metrics to measure the entire registration process

•  Good, Better, Best benchmark rankings

7

NAHAM Pre-Registration Process Tiers

LinktoNAHAMAccessKeys®

GOODBenchmark

EarlyImplementationPhaseorManualProcess

BETTERBenchmark

MiddleImplementationPhaseorSemi-Auto

Process

BESTBenchmark

MatureImplementationPhaseorAutoProcess

POS-1 Collections POSCollectionstoRevenuePOSCollections

NetPatientServiceRevenue 1.0% 1.5% 2.0%

POS-2 CollectionsPOSCollectionsto

TotalPatientCollectionsPOSCollections

TotalPatientCollections 30% 40% 50%

POS-3 CollectionsPOSCollectionOpportunity

RatePOSCollectionsPOSEstimations 30% 45% 60%

POS-4 Collections TotalPOSDollarsCollectedTotalDollarsCollected(<=DischargeDate)

POS-5 Collections POSCollectedAccountsRateAccountsCollectedTotalRegistrations 20% 40% 60%

POS-6 Collections EstimatetoRegistrationRateEstimatesGeneratedTotalRegistrations1

30% 40% 50%

POS-7 Collections EstimationAccuracyRateAccurateEstimatesQualifiedEstimates 85% 90% 95%

ID# DOMAIN AccessKey(KPI) EQUATIONNationalstandardbenchmarksrepresentprogressivephasestoachievingahigh

performingPatientAccessteamandarelargelydependentonthelevelofexecutivesupport,communityandboardadoption,availabletechnology,staffing,processesand

useofbestpractices.

TotalPOSCashCollectedcomparetopriorperiods(noratioorbenchmarkforpeercomparison)

NAHAM POS Collections KPI’s

NAHAM POSC Best Practices – “Good”

1.  Establish a Baseline ‐ What are your average POS collections per month? By Location?

2.  Identify Gaps - Assess the current POS collection policies, practices, training needs and technology at each Patient Access location (ED, Surgery, Outpatient, Pre-Reg, etc.)

3.  Provide staff with - Estimation and payment tools, training on insurance terminology, calculation of copay, deductible and coinsurance.

10

NAHAM POSC Best Practices – “Better”

4.  Train Staff - How to collect effectively (soft-skills customer training) with scripting, objection handling, and financial assistance options they can offer patients which are pre-approved by the hospital’s financial assistance policies (FAPs).

5.  Develop Collection Policies - Empower registrars to offer discounts, payment plans, loans and charity for those who qualify, and provide them with clear parameters to reschedule non-urgent services for patients that decline financial assistance.

6.  Foster a Collections Culture - With support from the Board, Executives, Management and Physicians, where every registrar asks at every opportunity, of every patient with an estimated liability, at every location and every time.

11

NAHAM POSC Best Practices – “Best”

7.  Continually Raise the Bar - As goals are met, raise the bar – but keep goals attainable.

8.  Implement Incentives - These can be non-financial (recognition, parties, etc.) or financial (depending on facility).

9.  Engage Physicians and Office Managers - To set expectations at ordering and scheduling levels.

10.  Monitor POS Collections Performance - On a monthly, weekly and daily at four levels; health system, facility, location and employee, using all 7 POS Collections AccessKeys.

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©2016CallidusCloud–Proprietary&Confiden/al

Increasing Collections Efficiency Through Training

Reviewing your present culture…

•  The “We’ll send you a bill” era is OVER. •  You are Helping Your Patients every time you

explain their financial requirements. •  Are your assumptions in the way?

Litmos POS Collections Curriculum

•  BF80920 Assumptions, Presumptions and Misconceptions in Collections •  BF80921 Triaging for Better Collections •  BF80922 Breaking Down Communication Barriers During Collection

Process •  BF80923 Three Keys to Effective Collection Communication •  BF80924 Matching Communication Styles for Improved Collections •  BF80925 Understanding the Stages of Patient Collections •  BF80926 Strategies for Handling Objections to Payment •  BF80927 Quality Assurance Methods in the Collection Process

Let’s Review Some Best Practices…

BF80920: “Assumptions, Presumptions & Misconceptions in the Collections Process” BF80922: “Breaking Down Communications Barriers During the Collections Process”

Some common assumptions about Point of Service Collections—Are They Yours?

•  Healthcare is too expensive •  You have to be mean to ask for payment •  Patients don’t have the money •  Patients don’t want to pay

BF80920:“Assump/ons,Presump/ons&Misconcep/onsintheCollec/onsProcess”

1. Healthcare is too expensive

It is best NOT to mix your personal feelings or opinions into the collections process - it is very difficult to do the job that way.


2. You have to be MEAN to ask for payment

Maintaining a professional demeanor and being the information provider is the best way to help patients and their families.


3. Patients don’t have the money

•  Unless you are a mind-reader, it is best to assume that patients want to pay for the services that they access

•  Most people get satisfaction from paying their bills and don’t want to owe anyone for long


4. Patients don’t want to pay

•  Recognize that this may be a personal assumption •  Don’t pre-judge - take each patient encounter as a

fresh start •  Always portray your expectation that the patient will

pay what they owe


How are your communications skills?

•  Different backgrounds, cultures and languages should not matter

•  You control your voice and the words you say •  Always the information provider •  Always professional and empathetic

BF80922:“BreakingDownCommunica/onsBarriersDuringtheCollec/onsProcess”

1. Different backgrounds, cultures and languages should not matter

•  You are the expert in their eyes-be prepared for your meeting.

•  Older than you? Show respect and ask how they wish to be addressed.

•  Using acronyms and healthcare jargon is a big no-no.


2. You control your voice and the words you say

•  Practice “low and slow” - a lower pitch to your voice is easier to understand and keep it slow and informative.

•  Practice “clear and precise” - correct pronunciation and articulation.

•  Always use simple and caring language.


3. Always the information provider

•  Talking while looking at a screen is confusing •  Be a focused active listener •  Demystify the terms you choose •  Make sure you paraphrase what you heard •  Clarify with your questions


4. Always professional and empathetic

•  Take time to show you care •  Look after their personal comfort •  Empathizing with patient builds trust and personalizes

their experience •  Encourages repeat customers


Why You Need Patient Estimates

The power of patient estimates •  Enable financial assistance discussions •  Reduce patient financial stress •  Increase the likelihood of collections •  Are cheaper to collect up front than after service

•  Automated §  Electronic Orders / Scheduling §  Demographics, Insurance, Procedure

•  Accurate §  Aligns with NAHAM standards §  Provides Accuracy Rate Guarantee

•  Workflow §  Alerts registrar to collection

opportunities

•  Employee and/or patient-facing §  Kiosk/portal/mobile

Not All Patient Estimates Are Equal

Es/ma/onAccuracyGuarantee™

•  Embedded into the POSC workflow

•  Prompts registrars in real-time •  Improves consistency of asking

for payment •  Increases staff confidence and

effectiveness •  Scripts: Standardization of

financial assistance options in sequence and per segmentation

Tailored Scripting for Financial Discussions

•  Aligns to hospital financial assistance policies

•  Screens patients based on ability and willingness to pay

•  Provides personalized scripting based on patient need

•  Prompts registrar to offer standardized discounts and loans

•  Meets 501(r) presumptive charity requirements

Financial Screening and Payment Options

Integrated Payment Processing

•  Integrated estimates/payment processing

•  Patient payment portals and mobile apps

•  Payment options personalized to each patient §  Credit/debit/ACH/cash §  Retail and EMV / Chip Reader §  Discounts (Prompt Pay / Amnesty) §  Flexible Payment Plans §  Loans (bank vs hospital)

•  Auto-posting for real time status •  POS collections/reconciliation

reporting

POS Collections Dashboard

Integrated Dashboards and Reporting

The NAHAM AccessKeys® KPI’s are fully integrated into our reporting: •  Estimates to Registration Ratio •  Collected Accounts Ratio •  POS Collection Opportunity Rate •  Total POS Dollars Collected •  (Others?)

Real World Results of Best Practices

1.  System: Patient estimation implemented

2.  Training: Classroom and elbow-to-elbow training

3.  Optimization: Integrated payment processing – “Pay Now” button

Amou

ntCollected

MonthlyTimeline

2x

3x

$0

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$350,000

$400,000

Oct-14

Nov-14

Dec-14

Jan-15

Feb-15

Mar-15

Apr-15

May-15

Jun-15

Jul-1

5

Aug-15

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Oct-15

Nov-15

Dec-15

Jan-16

Feb-16

Mar-16

Apr-16

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Jul-1

6

Aug-16

Es#mates Training

PaymentProcessor

Revenue Generation

§  Earlier cash §  Prior balance resolution §  Divert bad debt

Expense Reduction

§  Cost to collect §  Time value of money §  Early out and collections fees §  Aged Payments

The Financial Impact of POS Collections

THANK YOU FOR ATTENDING

Paul Shorrosh AccuReg CEO O: 251-338-3443 C: 251-209-0110

Terry C. Kile Regional Director O: 610-994-4959 C: 717-598-8970

[email protected]

[email protected]/healthcare

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