To help alleviate bad debt problems, Nashville, Tenn.-based Affiliated Creditors, Inc. (ACI), a 20-year-old collection firm specializing in healthcare for the last quarter-century, has incorporated a collections program into its practice that has won accolades from healthcare providers. "By focusing on the revenue cycle, we've developed a closed loop system for facilities to implement in their business office processes," explained Chad Williams, ACI vice president of sales and marketing. "This closed loop system helps increase efficiency, cash flow, customer service and satisfaction. From the schedulers to pre-admit clerks to the checkout process, everyone works together and does their part for the process flow to have minimum defects. If administrators can minimize defects, they'll be pleasantly surprised at how much money doesn't just walk away on a daily basis." Even though some critics might say the quality of care may suffer with this system, exactly the opposite has occurred, said Williams. "The process covers all the bases by evaluating the patient from the very first contact to determine the next step of the process," he said. "This contact not only helps the facility decide what it needs from the patient, but also educates the patient so he's not surprised with unknown expectations. "If healthcare providers don't want their account receivables to increase, they must constantly find creative avenues to help their patients meet their obligations. Whether helping with some financial assistance programs, grants or even promissory notes, all are with keeping the patients' best interest. Sometimes, the best medicine is giving the patient the peace of mind that you are there to help in sickness and in finance. By creating this bond, the facility will solidify its position in their respective communities as a leader and caregiver." It's crucial for providers to pay particular attention to patient relations, emphasized Williams. "How we meet, greet and interact with the patient is first area that attention needs to be given," he said. "The reflection of an office if a positive one can many times overcome errors or miscues by employees, but there is no loyalty to providers if there is no sense of respect. This is easily accomplished by a smile, honesty and treating people as they are treated. A happy office means a happy patient." Information is the key to analyzing accounts, said Williams. "Establishing the patient's ways and means to pay for services requires attention to detail: getting all insurance cards and verifying coverage and determining patient responsibility," he said. "By doing your homework and using or upgrading your computer system, you not only know what and who is going to be paying, but reduce bad debt by collecting the patients co pay, estimated balance or prior balance on or before the date of service. It doesn't do any good to get all this information only up front. You must constantly update your information, never taking for granted that when the patient returns, everything is the same. Always document each account with every contact whether by phone or in person. Patients don't like to repeat over and over the same thing they told someone else in the office. This makes them feel unimportant and upset and certainly gives them an 'out' of why they didn't or won't pay." Asking for money is perhaps the most difficult administrative process, Williams pointed out. "It's by far the most feared by employees responsible," he said. "But if all the bases are covered by developing a closed loop system, this becomes one of the easiest. The only way to help staff overcome these fears is through education. Teaching employees negotiating techniques not only helps them overcome objections, but also helps negotiate payment in full or higher. Making sure that proper staff are trained in knowing when to ask and how to ask not only helps generate cash flow but because the process has informed the patient of their obligations it becomes a routine and simple process." November 2006