Healthcare Collections

The struggle to do more with less is one very often encountered in healthcare. Having the right technology is critical to achieve optimal results. While identifying accounts that are more likely to pay is important, when dealing with limited resources or driving down the cost of collection, identifying accounts that are uncollectable is just as important. Healthcare collections management should include handling uncollectable accounts via a ‘no touch’ strategy and/or workflow automation. This allows valuable resources to focus on revenue-driving activities.

The first critical step in maximizing patient collections is understanding the financial health of each patient. Second, is to identify accounts that are uncollectable, applying touchless processing to reduce cost and resources spent with no return. Third, is to use financial insights coupled with technology and automation to apply the most efficient and cost-effective outreach strategy. Fourth is to ensure external self-pay vendors are performing at the highest standards via agnostic performance reporting. Finally, frequently monitor the results of each strategy and continue to optimize.

Imagine what it would mean for your organization's bottom line and financial wellbeing if you knew exactly who to collect from and be able to consider the financial status of each patient individually. Experian’s internal analysis has shown that health organizations who have no data driven collection strategy today are leaving a minimum of 6% patient collections on the table. Breaking this down further, depending on the size of your organization, if you are collecting $1M a month today, by not using a robust data driven collection strategy, you are losing out on an additional $60k a month or $720k a year. In addition, you are most likely sending those accounts to a collection agency. You lose out on these collections and pay an average of 15% contingency fee on top of that. Not to mention the repetitive and prolonged attempts trying to collect from the same accounts, causing staff burnout and reduced patient satisfaction.

Working your way down a list of accounts by focusing on the largest balances first or accounts with the shortest aging period is not a strategy that will yield the best results. Accounts with the highest balances may seem most appealing to contact and try to collect from, but that is not always the case. Healthcare collections software, such as Experian’s industry-leading scoring and segmentation tools, provides proven insights into identifying and grouping accounts into various tiers. These tiers are then used to create contact campaigns and outreach strategies so that efforts are focused on tiers that offer the biggest return on investment or highest yield. Experian’s segmentation separates itself from the rest of the industry as it encompasses many additional factors, such as Experian’s health risk score, which incorporates the consumer’s financial situations including credit scores, proprietary repayment history models, encounter-specific attributes, and demographic/address level details.