Four strategies to optimize patient collections

Experian Health products referenced in this blog post:

Healthcare may be historically more recession-resistant that other industries, but the COVID-19 pandemic has left many providers hurting financially, as many patients struggle to pay their bills. Patient collections were already a challenge, with declining Medicaid coverage and rising co-pay obligations putting patients on the hook for more of their healthcare expenses. Now, with millions of Americans out of work and missing out on employer-sponsored insurance, providers are being forced to adapt their collections processes to fit this unstable insurance landscape, or risk losing more dollars to bad debt.

Four key strategies can help providers seal the cracks in patient collections and stem the surge in uncompensated care. With compassionate processes that treat each patient as an individual, providers can use data and automation for more efficient healthcare charity screening, find missing coverage and identify both propensity to pay and the best financial pathway to minimize the chances of bills going unpaid.

1. Screen for charity eligibility early and often

Nearly 4 in 10 unemployed Americans have been without work for more than 27 weeks – the most since November 2013. As unemployment persists and benefits dwindle for many, more patients may be eligible for charitable support to cover their healthcare costs. Running presumptive healthcare charity screening as part of the collections workflow can help providers identify those who should be getting extra support.

Patient Financial Clearance runs automated checks when a patient registers, so individuals can be automatically enrolled as soon as eligibility is confirmed. Checks are repeated throughout the patient journey, should their financial situation changes.

Caye Mauney, Patient Access Director for Palo Pinto General Hospital, says the automated checks can confirm eligibility within just three seconds. This saves a huge amount of time for her team, while giving patients financial clarity without worrying waits: “All the information we need is now at our fingertips. The patient no longer needs to bring in check stubs or go back to a former employer to ask for information. It’s been a game changer.”

2. Find forgotten coverage quickly 

Automation can help providers cut uncompensated care by finding missing and forgotten coverage, even when patient case mix and payer rules are constantly changing. Healthcare organizations that quickly uncover previously unidentified coverage are often are paid sooner and avoid the collections challenges of self-pay receivables.

Experian Health’s Coverage Discovery uses best practices around search, historical information, multiple proprietary data sources and demographic validation to find previously unknown coverage. It continuously scans for insurance coverage to maximize reimbursements and minimize accounts sent to collections and to charity.

Learn from Banner Health how Coverage Discovery has helped the organization find 30+% unidentified coverage earlier in the revenue cycle.

Register for the webinar here.

3. Improve the collections experience with compassionate billing

Speedy coverage checks are just one way to give patients peace of mind when it comes to medical expenses. The collections process is often opaque and intimidating, hitting patients when they’re already stressed and vulnerable. The more compassion that can be built in, the better the patient financial experience will be. Unpaid bills go down, while patient loyalty goes up.

Transparent pricing, data-driven payment plans, personalized communications, and easy ways to pay all contribute to a positive patient financial experience. A good place to start is with Collections Optimization Manager, which allows providers to segment, support and monitor patients throughout the entire collections cycle. By connecting to a host of other patient-facing tools, this helps members feel taken care of from start to finish.

4. Use data to put patients on best payment pathway

None of these strategies will work without reliable, accurate data. Healthcare organizations traditionally rely on demographic and behavioral datasets, but this leaves gaps in how much is known about patients’ financial situations. Incorporating credit data can add a layer of valuable insights about a patient’s propensity to pay, so collections resources can be directed to the appropriate accounts. If you know a patient has a missed mortgage payment or delinquent loans, you can help them find alternative coverage and redirect them to a better payment pathway.

Experian Health combines demographic, behavioral and credit data so you can help your members navigate their health expenses with confidence. The result? Better financial health for both your members and your organization.

Find out more about how to optimize patient collections, whatever 2021 has in store, in our recent eBook, Recession-proof your revenue cycle. 

Download now.

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Success at a glance: patient-centric collections

With high-deductible health plans, larger out of pocket costs, and confusion about medical costs in general, it’s no surprise that patients today face increased financial responsibility. Unfortunately, the current pandemic has introduced an entirely new level of financial responsibility and uncertainty for both patients and providers.

Like many provider organizations across the country, Yale New Haven Health was feeling the impact of the changing healthcare landscape. Patients are finding it harder and harder to pay their medical bills, and more accounts are going to debt. The organization obviously needed to be compensated for their services and improve collections, but it needed to do so in a way that matched its mission and vision of providing high value, patient-centered care.

A few years ago, Yale New Haven Health turned to Experian Health to improve collections with an elevated patient experience.

With Experian Health’s Collections Optimization Manager, Yale New Haven Health was able to score and segment patient accounts based on who has the propensity to pay, determine how a patient could best resolve their bill and then direct them to the appropriate resources for doing so. The organization supplemented this activity with PatientDial, a cloud-based dialing platform that offers inbound and outbound communication options to increase collections.

While these efforts have improved collections for the organization in the past, they have proven invaluable for both the revenue cycle and the patient experience during COVID-19.

  • Increased patient satisfaction. A billing indicator was included for patients that might be experiencing financial hardship as a result of COVID-19, allowing the organization to hold that particular billing statement for 90 days. After 90 days, those accounts were again reviewed and evaluated for charity care as necessary. Patients have been grateful for the extra time and flexibility for payment during such a stressful event.
  • Continued collections. With these steps in place, Yale New Haven Health was able to maintain the regular daily statement production and movement of accounts through the revenue cycle for those not experiencing COVID-related hardship. The additional revenue supported the institution and helped to maintain collection levels as close to normal as possible during uncertain times.
  • Improved communications. Even with the 90-day delay for select accounts, call campaigns with PatientDial continued throughout the pandemic. Connection rates have increased by 5.5% month over month from January to present. Patients are not only pleased with the communications over balances due but are more receptive to attempts to resolve debt as the organization has approached billing-related communications in a more empathetic manner.


Learn More.

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Success at a glance: improved collections, part two

While all hospitals and health systems will no doubt encounter revenue-specific challenges related to the pandemic, a solid foundation and targeted approach for improved collections can help speed up the road to recovery. In fact, it was Sanford Health’s unique approach to increasing patient collections that allowed it to both optimize collections during the pandemic and improve employee satisfaction and retention.

Several years prior to COVID-19, Sanford took steps to improve collections with a patient-focused, hybrid approach that combines employee incentives with segmentation strategies.

Leveraging Collections Optimization Manager and PatientDial from Experian Health, Sanford was able to quickly and easily streamline call center operations and increase collections in a myriad of ways – through new and updated patient addresses, patient-friendly billing statements, identifying new guarantors and more.

With the above items in place, Sanford was already well positioned to seamlessly manage normal business operations during a pandemic. The organization was able to quickly adapt, and then build on that momentum to better serve its patients and staff, while also driving results.

Since the start of COVID-19, Sanford has:

  • Increased employee satisfaction with remote capabilities
    PatientDial allowed Sanford to seamlessly transition its call center team to work remote. Where about 30% of the workforce was remote prior to COVID-19, just shy of 99% of call center representatives are now remote. This has been a great source of employee satisfaction and safety and has aided in the system’s ability to keep the collections momentum going.
  • Provided a more compassionate approach to collections
    Recognizing that this is a sensitive time for many, Sanford ensured the proper mechanisms were in place to identify those who required additional help, offering the best methods for collection possible. Sanford has not only created a billing indicator for patients affected by COVID-19, but Experian Health has provided additional insight with a weekly file of patients who are identified as possibly financially stressed.
  • Improved collections during time of crisis
    While collections decreased for the quarter, Sanford saw a record increase in collections for the month of March — $800K more than the system saw in March of 2019.


Learn more.

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Success at a glance: improved collections, part one

Before working with Experian Health, call center operations at Sanford Health were disparate and disjointed, with each call center operating on a different phone system with different carriers. While some centers saw high abandonment rates, others were waiting around for calls. Although Sanford attempted to create balance by placing accounts in a work queue, the process for managing outbound collection calls remained manual and it was impossible to identify and strategically contact patients based on ability to pay.

Sanford took steps to improve collections with a patient-focused, hybrid approach that combines employee incentives with segmentation strategies.

Since working with Experian Health, Sanford now has a focused approach to managing accounts receivable (AR) by identifying patients with a certain propensity to pay. Collections Optimization Manager allows Sanford to quickly identify a pathway and delivery to resolution of the patient’s balance.

The analytical segmentation models within Collections Optimization Manager use precise algorithms that reveal those patients who likely are eligible for charity services, those who might prefer to pay in full at a discount, or those who might benefit from a payment plan. The solution then feeds segmentation data to PatientDial, which Sanford uses to route calls to 70 patient account representatives.

Sanford also implemented a re-designed, more user-friendly patient statement format. The improved cover page offers easy-to-understand information about the bill including the available options for payment.

In a larger effort to improve the patient experience, Sanford implemented an employee incentive program that appropriately rewards staff based on their collections’ performance.

Since working with Experian Health, Sanford has seen the following improvements:

Streamlined call center operations. With PatientDial in place, Sanford was able to consolidate its call center team members in 4 regions and seamlessly operate on centralized toll free and direct dial numbers. Where it used to take on average 56 seconds for a call to be answered, calls are now answered in 20 seconds or less. The system now comfortably manages an average of 12,000 inbound calls weekly.

Increased collections. The model in place has allowed Sanford to improve collections in a myriad of ways. In addition to increased collections from calls made through PatientDial, Sanford was able to see an additional $2.5M in patient payments by ensuring patient statements were sent to the new or correct address. The system found an additional $60K by identifying new guarantors for accounts of deceased patients. The segmentation capabilities from Experian Health also enabled Sanford to identify patients struggling with bankruptcy, allowing staff to focus their efforts on collectible accounts and more efficiently direct individuals to charity options.

Learn more about Sanford Health’s journey and how a similar approach could help your organization improve collections and employee satisfaction.

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