Pre-collection calling services and electronic bill presentment solutions provide impressive returns on investment.
By Mark Snow
When President Obama signed the Patient Protection and Affordable Care Act in March, it meant that healthcare coverage would eventually be extended to 32 million uninsured Americans. The percentage of the U.S. population that has health insurance would increase from 83 percent to approximately 95 percent. So, millions of additional people would be receiving healthcare services and be responsible for paying for some of their care.
With bad debt expense on the increase - and expected to rise even further - you can't blame those in the healthcare industry who may have said, "If we can't get all our patients to pay on a timely basis now, how will we get even larger numbers to do so?"
While many healthcare providers struggle with this question, many others are ahead of the curve. One company, California Healthcare Medical Billing, Inc. (CHMB), has been helping its clients manage their revenue cycles since its founding in 1995. Based in Escondido, Calif., the privately held company provides medical billing and reimbursement services to physicians, clinics and multi-specialty organizations. The company offers a comprehensive range of technology services - application hosting for electronic health records; technical support and training; hardware and software selection, implementation and optimization; and network services - to more than 1,000 physicians in 200 medical practices throughout California.
"Successfully managing business operations is crucial to every medical practice's profitability and long-term viability," says Janet Boos, the company's president. "CHMB focuses on the business side of healthcare, helping clients maximize revenues and cash flow, streamline operations, control costs and reduce compliance risks - and freeing them to concentrate on patient care."
The company's success has resulted in impressive growth that has earned it recognition as an Inc. 5000 "Fastest Growing Company" two years in a row. "We have to earn our business every day," Boos notes. "Providing our clients a range of outsourced services and continually expanding our offerings are the keys to satisfying our clients and ensuring our long-term growth."
Since its inception, CHMB offered a pre-collection calling service to its clients. The company's employees targeted clients' patients who had overdue balances, offering to take credit or debit card information over the phone to clear their balances. But according to Boos, the company had limited success with the pre-collection service. "We were only making live calls during regular business hours. Since we weren't calling when most people were actually at home, we weren't reaching many of our clients' patients. The service didn't have the impact our clients were hoping for, and CHMB employees were engaging in work that wasn't producing results and was increasing our labor costs. Still, we believed the right pre-collection service would be a benefit to our clients."
In October 2007, Boos learned about an interactive automated pre-collection calling solution, TELExpress, from Valley Forge, Pa.-based PSC Info Group. Boos was immediately intrigued because, in her experience, residents of California were more receptive to automated calling services than the American population in general. "Many businesses and schools had been using automated calling for years, and Californians had come to expect that such services were used to communicate important information."
The pre-collection calling application is an automated telephone call to patients to increase their urgency to pay balances in a timely manner, reducing receivable days and increasing in-house collections. Boos' interest in the solution increased when she learned that the average user of the calling service achieved a return on investment of more than 12 to 1 (i.e., for each dollar spent on the service, the user collects more than $12.00 they would not have collected without the service).
Using an interactive script in English or Spanish, the service authenticates the party, reminds them that they have an overdue balance, then collects credit card, debit card or check information; insurance details; and other information necessary to resolve their accounts. Patients may completely self-serve or automatically transfer to the healthcare provider's billing staff. The self-serve option is particularly popular among patients who may be embarrassed to speak with a live operator about an overdue balance.
The calling service allows hospitals and physicians to make thousands of interactive, personalized phone calls during prime time and with no additional staff. It also distinguishes patients who are willing to pay from those who are not likely to pay. The service is flexible and customizable with multi-tiered branching software.
The entire pre-collection calling application is Web based, so no additional software or hardware is required to implement and run the service. Customer support is provided as part of the product offering. "From a capital investment standpoint," says Boos, "the service was easy to implement - and no additional staff is required to operate the system."
As for the benefits of the system, Boos notes that, "In addition to increasing collections, the system instills patient accountability and increases their urgency to pay sooner. And the service improves our clients' patient-provider relations because of its professionalism and convenience."
"For CHMB and our clients, TELExpress has been a win-win," says Boos. "Our clients improve their collections by collecting more overdue payments more quickly. And we reduce labor costs by keeping CHMB employees busy with more productive work."
CHMB's patient statement services was another area Boos wanted to upgrade. "We had been working with a company that served our clients' patient statement needs for 12 years," says Boos. "But we weren't able to offer a solution that would enable a client's representative to view a patient's bill online while talking to them on the phone. This was very frustrating to our clients' patients. So we began looking for an electronic bill presentment solution. In spring 2008, we evaluated PSC Info Group's solutions called DATAExpress and DATAExpress View, comparing them to our previous vendor's capabilities and those of companies we had met at trade shows and conferences."
DATAExpress is a secure, state-of-the-art method for processing, printing and mailing time-sensitive business communications, such as patient billing statements. It also provides healthcare organizations the ability to view exact replicas of patient statements securely on the Web. Users can create customized statements for their clients, including the organization's own logo, and they can include personalized letters and other insertions.
"We switched to the new solution in the spring of 2008," says Boos. "The ability for our employees to view patients' bills online and for CHMB to customize statements for our clients was the biggest deciding factors in our switch to their solution.
"Communicating with patients electronically via e-mail and through a Web site provides interactive and convenient communications. Patients respond favorably - and more promptly - when their statements can be accessed from their computers. And the information is secure. Patients access their healthcare bills, which are in PDF format, through a password-protected Web page.
"The pre-collection calling service and the electronic bill presentment solution have become key components of our clients' entire healthcare patient/member communications life cycle. These services have given us an edge over competitive billing companies," says Boos.
About the author
Mark Snow is chief marketing officer and director of business development for PSC Info Group. For more information on PSC Info Group, click here.