The reality of inpatient collections
When done correctly, inpatient collections can be very effective. However, few medical centers have the staff, expertise, technology and governance to effectively execute and manage a comprehensive patient pre-collection process.
As a general rule of thumb, most medical and back office management systems focus on insurance billing and collection, which represents more than 75% of your total revenue. This leaves little time for billing and collection from patients. And, to be truly successful in inpatient billing and collection, the same focus and attention that is placed on the insurance side must be on the patient side.
Since this rarely occurs, most internal attempts to regain the patient’s balance produce mediocre results. Let’s see the reality:
Incoming phone calls:
Many administrators have told us that they fear the week following the release of account statements due to the influx of phone calls.
As a Practice Manager recently said, “My entire day can be consumed just by taking the time to explain on incoming calls what constitutes the balance shown on the statement.” The average time for a call to answer a question about the statement is more than 22 minutes.
With an average of 2,250 statements per month, even if only 1% of patients called with questions, that would consume a full 8-hour day for an FTE, assuming that was ALL they were doing.
Managers interviewed stated that they were understaffed and unable to handle all incoming calls. On average, more than 20 calls a day go directly to voicemail. When and if they have time to return calls, they are rarely able to reach someone.
This is lost income. Patients may be calling to update insurance information, provide secondary insurance, to get an answer to a question, or to make a payment on their account.
Phone calls from outgoing patients:
If staff don’t have time to effectively handle incoming calls, which represents a small percentage of their patient base, how are they going to find the time to make outgoing phone calls?
Staffing to reach large numbers of patients is extremely expensive. And getting them during normal business hours is difficult, if not impossible.
It’s easy to see why most medical billing staff feel overwhelmed when it comes to communicating with patients during the 90-120 day pre-collection time frame.
With so many factors to consider and so much money on the table, outsourcing the pre-collection process may be worth considering.