Breakthrough Strategies Leading Practice Self-Pay Solutions Presented by: Phil C. Solomon NC HFMA Chapter – March 17, 2009 Proprietary and Confidential This information is not to be copied or otherwise utilized without the written consent of UCB, Inc.
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Breakthrough StrategiesLeading Practice Self-Pay SolutionsPresented by: Phil C. SolomonNC HFMA Chapter – March 17, 2009
Proprietary and ConfidentialThis information is not to be copied or otherwise utilized without the written consent of UCB, Inc.
Page 2
Session Overview
Learning Objectives:
Healthcare industry financial overview
Review the economic factors causing the rise in self-pay
Identify new tools, technologies and strategies to help you to address the increasing self-pay patient population
Breakthrough Strategies
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Session OverviewBreakthrough Strategies
“If you think you can….. or if you think you can’t….. you're right”
~ Henry Ford
Page 4
Question
The new healthcare bill will eliminate all self-pay accounts?
Breakthrough Strategies
TRUE or FALSE?Chat
Page 5
Answer
Expect increase co-pays deductibles
Premiums increases
Patients look to reduce premiums
Breakthrough Strategies
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Healthcare Industry OverviewBreakthrough Strategies
Real time eligibility checkFlat fee pricingWaterfall cascade check:
Medicare/Medicaid Commercial Commercial propensity Prime, second, tertiary Patient historical data Employer Other demographics
Page 29
POS CollectionBreakthrough Strategies
Institute for Health Care Revenue Cycle Research - A Division of Zimmerman, LLC. National Pledge to Reform Uncompensated Care Reform Underway: Adopting Best Practices to Reduce Uncompensated Care and Improve the Patient Experience. a special supplement to PATIENT PAYMENT BLUEPRINT™
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POS Collection ToolsBreakthrough Strategies
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POS Action Strategy Breakthrough Strategies
Financial Assistance
You may qualify for Medicaid? Let me help you You may qualify for our charity care program?
Let me help you
Patient Pay
Will you be paying cash, check or credit card? Do you have a credit card on file with us? Let me show you how you can take advantage
of our prompt payment and self-pay discount Let’s set you up on a payment plan………..
An activity indicating the possibility of identity theft
Chat
The Answer Is?
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AnswerBreakthrough Strategies
A pattern, practice, or specific activity that indicates the possible existence of identity theft
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What is a Red Flag?Breakthrough Strategies
Red Flag Categories Alerts, notifications or warnings from a CRA Suspicious documents Suspicious personal identifying information Unusual use of, or suspicious activity relating to, the
covered account Notices from customer, victims of ID theft, law enforcement
authorities, or other persons regarding possible ID theft in connection with covered accounts held by the organization
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Best Practice Self-Pay ModelingBreakthrough Strategies
Patient Demographic DataZip+4 Census DataActual Collection Performance ValidationPatient Payment History – Custom ModelFinancial Credit Bureau DataNon-Credit Economic DataRed Flag AlertsSkip Trace Data ValidationDual Validation Income EstimatorCharity Lifestyle Evaluation
Must be delivered in real time
Page 47
Other Collection SolutionsBreakthrough Strategies
Recourse – Non-recourse funding
Good or bad?
Healthcare Credit Cards
Personal lines of credit
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Self-Pay Bad Debt ChallengesBreakthrough Strategies
Cultural behavior and lack of control slows placement to agency
Stigma about placement – conflict with mission
Myth - must use multiple agencies to maximize performance
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Self-Pay Bad Debt SolutionsBreakthrough Strategies
With new processes, only “true” bad debt accounts get placed
Know which accounts to write off sooner with modeling
Analytics and segmentation minimizes the need for champion vs. challenger
Minimize the need to work accounts too long
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Self-Pay Bad Debt Strategies
Lowest scored accounts average 50%
Reduce statement cost by accelerating placement
Low scored accounts – accelerate to collection agency
Treat each segment similarly, accounts can be reported on Medicare cost report sooner, leaving “collectable” accounts with agency longer
Breakthrough Strategies
Page 51
Question
In order to meet Medicare cost reporting guidelines, you are
required to work accounts internally for 120 days?