Roles of Staff, Technology in Patient Collections

Here is the second part of a two-part interview with Stephen Dickens, senior consultant with State Volunteer Mutual Insurance Company, a Brentwood, Tenn.-based, professional liability company and Jeff Wood, vice president of product management at Navicure, Inc., a provider of medical billing software solutions, based in Duluth, Ga. on their presentation at the  MGMA 2015 Annual Conference in Nashville, Tenn.

Dickens and Wood’s session is focused on developing strategies to help practices collect a greater percentage of receivables from patients who are now covered by new insurance products such as high-deductible insurance plans. In part one of the interviewPhysicians Practice spoke with Dickens and Wood about the importance of developing better patient collection processes and the first things practices can do to improve that process.

Below are excerpts from part two:

Physicians Practice: Are there technology solutions to help practices collect patient balances?

Jeff Wood: [If you can] gain the commitment of the patient, to say, "I'm willing to pay up to X amount, and there's a limit," then we swipe the credit card and store the credit card on file. So that when the claim is adjudicated and the final amount is known, then the practice can hit the card for that exact amount. And like I said, there is a limit that has been established with that estimate, so that the patient knows they are not on the hook for potentially thousands of dollars.

We find practices that are still storing credit cards on pieces of paper and writ

ten down - which is a huge security concern. [It is safer to] store that card in an electronic way; the technical term is "tokenized."

PP: Can you explain the process of "tokenizing" credit card data?

JW: You can swipe that credit card and it is tokenized or encrypted so that the practice can't see what the number is, but they have the ability to generate a charge against that credit card. So that is a much better way than the old method of writing down the number or the old carbon-swiper thing that you used to have. That's obviously very inherently insecure and only as good as both the employees, as well as anyone who may have access to the filing cabinet.

Stephen Dickens: And what Jeff is saying absolutely true. It's amazing the things that we will [see] and that's one of the first things we point out. "Do you realize the security risk that you have here? You are putting yourself in the position [of a HIPAA breach] if this is lost or stolen … and what it will do to you from a public relations perspective."

PP: How should staff members approach patients about paying copays, deductibles, and outstanding balances? And when should that happen?

SD: Our recommendation is that it should begin on the front end. When the patient calls and makes an appointment, if there's an outstanding balance that is something that should be looked at [right away]. And [staff should] remind the patient, "Remember you'll have a copay that's due. Or, you have an outstanding balance." It really begins at the very start, when the patient makes the appointment, reminding them of their obligation. And then when they get in the office, the people at the front desk have to be prepared to have these conversations, in an appropriate fashion, with patients.

PP: What type of staff training should practices provide?

SD: [Staff members] need a toolkit of the right things to say and the way to say it. The last thing you want is an explosion at the front desk from a patient who is surprised. "Well, you've never charged me before." Or, the patient says, "Well, I didn't bring my checkbook." So, they need to be prepared how to do this thing. And it requires that you have staff at the front desk that know what they are doing, and have been trained. A lot of practices think that anybody can sit at the front desk and that's not really true.

PP: Some administrators say that it is necessary to educate patients about their financial responsibility. Is that true?

JW: Absolutely. That's definitely something that we hear. There are still a number of folks out there who really want to walk out the door without paying anything. They'll say, "Can't you just bill me?" or "Can you catch me on the back end?" And this is where it is going to take retraining and sort of recalibration among the staff. To say, "You know what? We are all in this collections business now, and if we let everyone walk out the door, it's going to be hard to make payroll if everyone [says] 'I'll catch you on the back side.'" It is a major concern, and I do think that a lot of staff have a little bit of difficulty upfront [asking for money], but to Steve's point, with adequate training and coaching, it is a new world. And that's what practices have to adapt to. 

SD: I love that point Jeff. You really have to get staff to the point that they understand that they are part of this. "I have a role in this; this impacts my income, not just the physician's income."

Stephen Dickens, JD, FACMPE, and Jeff Wood are featured speakers at MGMA. Their session, "Reorient Your Patient Collection Strategies Around Your Patients" is scheduled for Monday, Oct. 12, from 10:30 a.m. to 11:30 a.m. CT.