In addition to this registration screening tool, the facility also uses SSI/SSDI Outreach Access and Recovery, or SOAR, a software provided by a Delmar, NY, company that concentrates on qualifying homeless individuals in need of care.
"Since we launched this 18 months ago, I've gotten less than five complaints. I think the key is how you approach the patient. We aren't twisting arms and legs. We approach them in a respectful and informative way," he says.
The new software enables the team to give the patient a more accurate estimate of the bill and the out-of-pocket copay. Though New Hanover Regional had been doing estimates for years, the accuracy of the estimates was much lower, and thus so were its collections. "Today it's much more refined and we get much closer; the accuracy has made a difference."
A fresh approach
The University of Virginia Health System, an academic medical center in Charlottesville, VA, also is looking into more proactive approaches. Larry Fitzgerald, CFO, says that in the past two years the 613-staffed-bed facility has seen growth of 12% to 13% in its charity care. Perhaps more disconcerting, Fitzgerald says, the percentage of gross revenue from self-pay patients in the first seven months of their fiscal year, ending June 30, hit 8.1%, up from a previous year-end total of 7.6%.
"In the last year, we've had self-pay patients who never thought they would be self-pay patients—but they lost their jobs and don't have insurance," he says.
To offset the influx of patients and to try to keep costs steady, Fitzgerald says the medical center is actively encouraging patients to use free clinics for nonurgent care and is looking for other opportunities to get to the problem at the source, before it gets to the bottom line.
"Right now we are analyzing the possibility of developing a primary care clinic for uninsured patients," he says, though this is still in the research phase. "These patients tend to come to the emergency department for things that could be treated in a primary care setting, and doing so would probably end up saving the hospital money."
Though it has managed to maintain a collection rate of about 20 cents for every dollar owed for self-pay patients, the University of Virginia Health System would like to see the dollars or patient levels shift in their favor. So it is seeking as many avenues as possible to change that, from the free primary care clinic to becoming an accountable care organization. "The numbers are rising; you have to look at new approaches," adds Fitzgerald.
Four Strategies for Stronger POS Collections
The financial leaders we spoke to regarding self-pay collections all approach point-of-service collections differently for self-pay patients. However, most had similar strategies for the basics, including: