3Today’s Topics Optimizing Self Pay Collections Automated Patient NotificationsT.J. Bauer from TelevoxPartnering with the Revenue Cycle TeamJIRA SuccessBilling and Claims JIRA meetings
4Self Pay Collections: Simplify and Optimize Jane SpeyerSenior Billing Manager, OCHIN
5Optimize Self-Pay Collections Self Pay Aging DateAccount Workqueues:Advantages of Drop Cycle StatementsSmall Balance Write off and Statement SuppressionSending Accounts to a Collection AgencyStatement InterventionAutomate Patient Collection Calls
6Self-pay Collections Lots of variation between clinics We have the ability to customize but what seems to work best?OCHIN continuously looks for ways to optimize, automate and simplify the workHere are our recommendations:
7Self Pay Aging DateThere are 3 options for setting the self-pay aging date:Service DateReflects actual age of servicePatient can get a statement saying service is 60 days past due when it was just NRP’d to patientPost Date Item doesn’t age until it is posted to self-payStatement DateItem ages when statement is accepted
8Account WQ Settings: The Basics No Rules Insurance WQReturned Mail WQPayment Plan WQCan set up a insufficient payment WQConfidential, Contested and Hold Statement WQSelf Pay WQ – 30 days and olderCan split by guarantor last name to split the workload between collectors
9Self-Pay over 30 days WQThis is where the bulk of your collection activity occursImportant Settings:Exclude Account Status ofReturned MailHold StatementsContested AccountsPayment PlanExclude Confidential AccountsSelf pay Aging of 30 days or moreOne or more statements sent
10Drop Cycle StatementsAccounts qualify for statements when charges drop to self-payEnsures that patients get a statement soonerDecision pointsIf patient incurs new charges, should they get a new statement right away?When should their next statement be sent?When should you remove them from the cycle?
11Drop Cycle Recommended Settings What to ask for when you request Drop Cycle:First week after you switch, you will have high volume of statements go out at oncePrepare patients and customer service staff for change
12Statement Suppression Do you really want to send statements on low dollar accounts?Cost of collecting isn’t worthwhileConsider suppressing statements for accounts under a certain amountIndustry recommendation is under $5.00You can also set up the system to automatically write off these low $ accounts at the time of statement processing
13Automatic Collection Workqueues If using a collection agency, make sending accounts to collections easy!External Collection Workqueue can:Send a data file to your collection agency with new accounts to be addedSend an update file with information about accounts removed from collectionsSend a payment file showing payments taken at clinic on accounts sent to collection agencyMake sure your agency integrates with EpicProfessional Credit Services (PCS) is fully integrated
14External Collections WQ Accounts placed in External Collection WQ will be:Written off to Collection Agency Bad DebtGiven an Account Status – your choice:CollectionsBad DebtCash at time of Service, etc.Will enter an Account Note (clinic can decide what it says)
15Statement Intervention Stops statements from going outUseful when there is retroactive Sliding Scale Discount eligibilityProgramming point looks at charges that qualify for slide, but no slide appliedPrevents statement from going out and drops it into a Statement Intervention WQAllows you to correct error and if there is a balance, account will qualify for next statement run if you use Drop CycleOther uses?
16Televox Automatic Patient Balance Notification OBS piloted this service at one of our clinics:Self pay collections increased $5,000/monthThis represented a 40% increase!In sample review of accounts that received a Televox call:41% made a payment16% called to report insurance or apply for Sliding Scale Discount
17Patient Balance Notification T.J. BauerEnterprise Account Executive TeleVox Software, Inc.
18Benefits for OCHIN Members Increase Self Pay Collections Patient Balance Notifications Simple Communications – Significant ResultsBenefits for OCHIN MembersIncrease Self Pay CollectionsMaximize ResourcesEffectively move from outbound to a mostly inbound call centerIncrease touchesDirect to on-line paymentsFewer statementsDecreased A/R lifeIncreased focus on more severely delinquent accountsReduce bad-debt write-offsIdentify need for assistanceStrategy OptionsHigh balance vs. Low balance LogicGet paid after hours using Inbound Payment OptionsVoice tone changes based on account agingOCHIN
193 Strategies for Maximizing Results Patient Balance Notifications Simple Communications – Significant Results3 Strategies for Maximizing Results1. Courtesy: Simple alert & offer of convenience2. Interactive: We’re here to help3. Final Notice: Action required0-60 DaysCourtesyToneNeutralFirmFriendlyCall Back Number or Live TransferLive Transfer / Pay-by-PhoneCall Attention /Online Bill PayDay or NightNightStrategyTime of DayDaysFinal Notice60-90 DaysInteractiveOCHIN
20Patient Balance Strategy Scripts (No Payment Option) Patient Balance Notifications Simple Communications – Significant ResultsPatient Balance Strategy Scripts (No Payment Option)Courtesy: Simple Alert and Offer of Convenience“Hello, this is Central Health Clinic calling with an important message for (Patient Name). Did you check out our quick online bill pay option at If you have recently mailed your payment, thank you. Please call us at if you have any questions about your bill. To replay this message, press 2.”Interactive: We’re here to help“The Central Health Clinic has an important matter to discuss with you. You can reach us Monday through Friday from 8 a.m. to 5 p.m. by calling If you would like to speak to a representative at this time, please press 1. To repeat this message, please press 2.”Final Notice: Action Required“Good evening. This is Central Health Clinic calling with important information about your outstanding balance. To speak with a staff member about your balance or make a payment, please press 1 now or call between the hours of 8:00 a.m. and 5:00 p.m. at your earliest convenience. Thank you for your attention to this important matter. To repeat this message, please press 2.”OCHIN
21Outreach Sample: PaymentIVR (Outbound + Inbound) Patient Balance Notifications Simple Communications – Significant ResultsOutreach Sample: PaymentIVR (Outbound + Inbound)Live Answer (Outbound Call):“Hello, this is Central Health Clinic calling with an important message for <Sherrie>. If we have reached the correct party, press the 1 key now...For right party verification, please verify we have reached the correct party by entering your date of birth (or SSN). Thank you! This is a courtesy call to advise your balance in the amount of <$250> is outstanding. Press the 2 key to speak to a member of our staff or press 9 now to make a payment via our automated payment attendant.Answering Machine [With Inbound Call Option]:Hello, this is Central Health Clinic calling with an important message regarding your account. For more details, please contact us at during regular business hours. [To make a payment after hours, please call <800-PAY-MENT> and enter the 5 digit PIN number of <12345>]. Thank you!OCHIN
22Processing vs. Non-Processing Patient Balance Notifications Simple Communications – Significant ResultsProcessing vs. Non-ProcessingAll IVR MessagesCalls DeliveredMessage PlaysRPVDOB/SSNPress 9 toPay NowEnter into IVRData FileProcessed Method (Automated)Validated by ProcessorPayment OptionsEnter CC DataPayment Processed$ Deposited to customerNon-Processed Method (PCI Vault Storage)PCI VAULT StorageCustomer decrypts fileCustomer Manually processes paymentsPayment OptionsEnter CC DataOCHIN
23Patient Balance Notifications Simple Communications – Significant Results Case StudiesOCHIN
24Patient Balance Notifications Simple Communications – Significant Results Case StudiesOCHIN
25Patient Balance Notifications Simple Communications – Significant Results Why TeleVox?Trust of the IndustryServe over 140,000 providers750+ enterprise healthcare clients, including U.S. News “Honor Roll Hospitals”Recommended by over 100 industry partners, including GE, Epic, Cerner, NextGen and AllscriptsZero RiskProactive data security approach (external SSAE 16 and HIPAA audits)Dual Data Center to ensure system resiliencyTrusted OCHIN partner for over 5 yearsCommitment to ServiceImplementations within 30 daysOver 80% of support issues resolved within 24 hoursIndustry-leading 99.97% call completion rateOCHIN
26Partnering with the Revenue Cycle Team Jane SpeyerSenior Billing ManagerOCHIN
27JIRA Secrets All these great improvements require a JIRA What can I do to get my JIRA’s worked faster?Chocolate might work, but these tips will work even better:
28JIRA Tips and TricksWhen reporting a problem, always include multiple examples.If it’s a claims issue, use invoice #, not account #, MRN or patient or account nameWhen listing payors, include the payor ID (not the name)Find the payor ID by clicking on “Coverage Summary” when in Account MaintenanceCheck registration for User Errors for claim rejectionsClaim Edit WQ Companion is truly a great companion!
29JIRA Tips and Tricks Keep separate issues in separate JIRA’s Can be confusing to follow and might lead to your JIRA being closed without every issue being addressed.You can link JIRAs if information is related or relevant to the other issue you are reportingOnly reopen the JIRA if the original resolution did not workIf a new issue or enhancement to the original issue is needed, open a new JIRALink the closed JIRA if it’s relevant
30More Tips and TricksUse CPT codes and ICD-9 codes or ranges of codes, not descriptions when requesting charge rulesAvoid delays in requests for info by being as specific as possible in your first entryIf asked for info, respond right awayYou want your fix, and your analyst wants to close the JIRAGive them what they need so you both get what you want!
31Billing/Claims Issues Meetings Making the most of them Get the right people in the room:The biller who requested the JIRAThe person who enters themThe person with system knowledgeThis person may or may not be the site specialistThis will allow your analyst to get the questions they have answered so they can implement the changes you need right away
32Billing/Claims Issues Meetings Making the most of them Prepare for the meeting by reviewing your JIRA listKnow going in, which JIRAs are most important to youReview JIRA’s to make sure your answered any requests for infoTest early and oftenOr you might lose your build!Pay attention to REL refresh datesReport that the Test is done so your fix can be moved into Production
33Billing/Claims Issues Meetings Making the most of them Use this time to ask your analysts about new problems that the system might be able to resolve for youThis is how system improvement happensThe Revenue Cycle Team needs to know what areas in the Rev Cycle are inefficient, difficult, or repetitiveTogether you may be able to create an elegant solution to an inelegant workflow
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