"The reason I am so passionate about the pre-service center is it is part of the front end of the revenue cycle. The focus has always been on the back end. If we can get it right on the front, it mitigates any surprises on the back. If you can minimize the rework, you are able to reduce costs," he adds.
The pre-service center's 12 full-time employees have also been trained to call patients who are scheduled for an appointment for which there will be a substantial out-of-pocket responsibility.
"If they do have a responsibility for a high amount out of pocket, we do outbound calls to inform them. There is an opportunity here to educate patients so they don't get the sticker shock on the back end. It's also to engage with them. If they don't feel they can pay, we'd rather have that discussion up front than after they have received care," Richmond says.
During the call, patients are also offered the opportunity to prepay their bill.
"As we are telling the patient about their out-of-pocket responsibility, we ask if they would like to make a payment up front. Some do, and some want to wait until the time of service. It's not about collecting payment at this point. The main thing is about educating them about their responsibility," Richmond says, noting that so far, MetroHealth is collecting about 15% of patient balances up front.
"Right out of the gate, we started seeing some success. … We've even seen some collecting of dollars right from the start. It's a small amount, but it is still a success," he says.