Hospital's Pre-registration Efforts Pay Off in Collections

In February of this year, Baptist and McCulley's team decided to outsource its prearrival responsibilities 24 hours in advance of the appointment. The goal is 90% pre-registrations, which includes obtaining pre-authorizations, verification of benefits and patient contact for collections.

Upfront collections means the hospital does not have to pay fees to a company to collect after the service (and while the account sits aging in AR).

It's too early to measure its effectiveness, but McCulley says the percentage of pre-authorized patients and upfront collections have each increased. Baptist also saved five FTE positions because of the outsourced work.

As an added benefit for physicians offices, the outsource company obtains their pre-authorizations as well as those for the hospital. This was not meant to eliminate jobs; rather just allow physician office staff members time to complete other duties.

McCulley states the impact of increased pre-registrations on processes as well as point-of-service collections is already showing a positive trend.

Patients who are scheduled for elective services and have not received financial clearance are given the option to reschedule. Of course, the revenue cycle staff first checks with their physicians first before suggesting a reschedule.

"We don't do it without making sure the doctor feels it will not be harmful for the patient to reschedule," McCulley says.

And naturally, Baptist offers a variety of payment options to avoid rescheduling – from upfront and prompt pay discounts to bank loan arrangements.

"Some patients say they can't pay, then when you ask them to reschedule, they write you a check right then and there," McCulley says. "Once they know the appointment will be canceled, with their physician's approval, it's surprising how many people come up with the money."

Editor's note: This is the fifth in a series of stories on HealthLeaders Media talking to revenue cycle managers about coping in a tough economy. The previous installments were:

• Hospital's 'What If' Scenario Becomes Reality
• Hospital Department Leaders Must Remain Flexible in Difficult Economy
• Lessons for Hospitals in a Tight Economy
• Hospitals Get Financially Smart in a Tight Economy