Category Archives: Collection Policy

Surviving the Deductible Season

The Problem –

The deductible season gets longer every year.


Why? One reason for the increase in annual deductibles is the growth in enrollment in High Deductible Health Plans (HDHPs).

According  to KFF Employer Health Benefits Survey, 2018-2020; Survey of Employer-Sponsored Health Benefits, 2007-2017 (Figure 7.19),  you can see that percentage of workers with deductibles over $1000 has risen from 33 percent in 2009 to 69 percent in 2020. Over the past 10 years, there has been a complete flip in the employee’s contribution to the annual deductible.  This shifts a greater portion of out of pocket cost to the employee.

When you couple higher deductibles with the fact that nearly 40 percent of adults  cannot cover an unexpected expense of $400 using cash, savings or a credit card which could be paid off at the next statement. This reinforces how important it is to focus on the collections during the intake and the first 90 days.

The Solution

Join Allegiance Group’s Bruce Gehring and Prochant’s Joey Graham  to learn how you can avoid a cash flow slump in  2021. You’ll leave this webinar with the tips you need to survive — and thrive — during deductible season.

Learn the answers to questions like:

Should you implement a hold on your insurance claims temporarily and let OTHER providers take the deductible hit?

How do you deal with the payer changes that occur at the beginning of the year?

What impact does capturing payment information at intake have on future collections?

Learn the answer to this questions and more

Collection Policy Part 6: Capturing Patient-Pay Balances

Many patients feel healthcare is too expensive. Combine that with the number of high deductible plans on the rise, collecting payments from patients can be challenging. A survey by West, found that nearly three in five Americans delay paying their medical bills. And as each of you know, the longer a bill goes unpaid your chances of collecting the balance deceases. As a result, a certain percentage of patients who you work with will not pay their bill. Many of you deal with this scenario all too frequently! You know the importance of capturing your patient-pay balances.
Continue reading Collection Policy Part 6: Capturing Patient-Pay Balances

Collection Policy, Part 5: How to Use Your Collection KPIs

It’s important to know how to use your collection KPIs once you have launched your collections policy. Review your key performance indicators (KPIs) on a regular basis. By keeping an eye on your trends, you will know if you need to adjust your policy or procedures.  Here are some examples:

You discover your days sales outstanding (DSO) is more than 50 days.  According to your policy, you are sending out two invoices during the first 45 days. You may want to adjust your policy by adding a reminder call between the invoices to help collect the balance sooner.

Continue reading Collection Policy, Part 5: How to Use Your Collection KPIs

Collection Policy, Part 4: Four Tips for Communicating your New Culture

There is usually a good reason you want to make a change in your organization – you are seeing moves in the competition, experiencing pricing pressures or seeing a rise in patient AR. Whatever it is, there is usually pressure to move quickly to improve results. Research shows that companies with strong cultures tend to be higher performers.  To help you get started, we’d like to share four tips for communicating your new culture.

I have helped implement culture change in three departments. The most dramatic was when I worked in a large Credit Card Center. The organization started a 24/7 call center to support its new data communication software. The system sent data from the gas pump to service station backroom to our data center. The workflow involved several hardware and software vendors at installations. Once installed, if data communications stopped the station could have a variety of issues such as not being able to pump gas, sell food in the convenience store or submit their daily paperwork.

The experienced CSRs on my team had to troubleshoot to quickly determine the root cause of the problem and dispatch the proper technicians. Since the data communication was critical, the company wanted to empower the team to streamline their workflow, be involved in the hiring process (to make certain any new team members would fit into the new culture) and provide peer feedback for reviews.

Finding a model – Jay Galbraith’s 5 Star Model

Our team used a process similar to Jay Galbraith’s 5 Star Model. We spent time on each “point” – strategy, structure, process, rewards and people.  The points are self-explanatory, but I’d like to comment on a couple of them.

    • Processes. We selected a small group of CSRs to help us examine each step in our workflow to determine whether it added value. If it did not add value, we tried to eliminate the step to streamline our workflow. This was a hard process because CSRs sometimes found it difficult to give up non-essential tasks.  By including the CSRs in this decision-making process, it was easier to get the buy in and support for the changes from the rest of the CSR team.
    • Training (People). Because we wanted peer input on reviews, the CSR team completed interpersonal skills training. This training was critical to the success of managing this change.
    • Rewards. We spent a lot of time on this topic because we wanted to make certain we were rewarding the right actions. I think we have all set a goal, and then our CSRs do something to reach that goal that we did not consider.

Before I leave this model,  I want to highlight the lines that demonstrate how each of the points impact the other points. This is an important concept you cannot forget when introducing change.

Change can be challenging

Whether you are looking to completely overhaul your processes or want to make some small adjustments, change will impact the dynamics of your team. For me, going through the culture change was not only the most difficult, but the most rewarding job I had with the company. Why? I learned that no matter how much you want introduce change, if your employees don’t want to change, your team won’t change.  So, once you have formalized your team’s culture, collection policy or collection procedures, you may want to consider these four tips for communicating your new culture:

 1. Effectively communicate your culture and collection policy to establish accountability at every level of your organization.

The most common mistake in trying to bring about change is to have the leadership team define it, talk about it once and then check it off the to-do list. Remember, you are providing everyone in the organization with a road map on how they are going to be part of something exciting. Describe how you envision the future. Match your message to your audience—you may need to adjust the tone, pace and style for the different groups. Make sure your communications align with culture. If your organization is formal and structured, your communications should be too. If you are more casual, your tone should reflect that. In our case, we had a different presentation for the leadership team, the CSRs and our HR partners.

You can’t just hand out your new vision and expect your staff to understand what you are trying to accomplish. Your culture team spent time thinking and discussing the changes. Therefore, your staff will need some time to understand why your culture must change and to process the changes you want in your culture. Some consultants recommend that when you are announcing the change, if you set aside an hour, spend only 15-20 minutes on the explanation to allow plenty of time for Q&A.

2. Keep the new culture guidelines top of mind.

Since culture change is important to your company’s success, you should address it often and publicly recognize individuals or teams that exemplify or demonstrate your new culture and what you aspire it to be. You might consider formal training sessions or team meetings. Our leadership team and  staff went through the interpersonal skills training together.  We also held team meetings every other week to discuss what was working and what still needed to change. Change is challenging, so the meetings were a good opportunity to keep employees motivated.

Demonstrate the values you want to emphasis by walking your talk. Since employees will pay more attention to what you do than to what you say, your leadership team should consist of strong cultural fits. They serve as the faces of the company and will show others how to live the corporate culture every day.

3. Prioritize your company’s results.

We recently went through this process at Allegiance Group. After creating a list of goals we wanted to accomplish in 2019, we narrowed the list down to the top 3-5 results. Next, we pick the activities that will have the most impact on those results.

As I mentioned, we invited CSRs to join our culture committee. This follows the recommendation of Connors and Smith, authors of the Oz Principle, to involve your staff to help determine what actions they:

– should stop doing
– need to start taking
– continue doing to reach their results

For example, when reviewing your workflow, you might decide that your employees should:

– Stop telling patients that they don’t need to pay now. You will want to collect payment upfront, and not wait to send an invoice until the insurance is billed.
– Start collecting payment information upfront and discussing the patient pay portion before the service is performed.
– Continue serving as a resource for your customers and doing the research in order to answer any questions.

Consider creating team-based as well as individual results. Team goals will demonstrate the importance of putting the organization’s interest before their own. For example, you might consider using collection recovery percentage or DSO as a company-wide result to help focus your staff’s efforts.

4. Monitor your progress and celebrate short-term wins.

Lastly, monitor your progress to make certain your results are improving. Make sure your results are driving the right activities.

Change is hard and sustaining it can be challenging. Plan for and create short-term wins so you can celebrate those who are excelling. Also, take the time to encourage those who were just short their goals and coach the CSRs who missed their goals.

Another way to monitor progress is to observe how your employees respond when an issue arises. Are they able to resolve it without involving their manager? Do they keep running into roadblocks?

Recognize you may have employees who won’t accept change. Try to turn a negative into a positive. Coach them to make certain they understand why change is necessary or offer a job challenge to help get them motivated. If you ignore them, their behavior will eventually have a negative impact on the whole team and make it harder to incorporate the changes you want to make.

Survey your employees to see if their values and beliefs are aligning with the company’s.

Your goal is to have your staff see how their daily actions help achieve the company’s results.  Each of your employees should be able to explain their contribution. For example, a collector should be able to fill in the blanks:  My job is to collect XX% of our patient pay AR and here’s how I do it:

I collect payment information for each patient upfront and store it in our system.  By doing so, when it’s time to generate the invoice, we can process the payment at the same time. We can collect the balance without additional work. Collecting the balance faster, improves our collection percentage and cash flow.

One last tip…

Find a few “change agents” to help you make forward progress. Every company has respected leaders — both formal and informal — who are ambassadors of your culture. Recognize them for upholding the culture. Encourage them to align their work and management styles so they can keep demonstrating what it looks like to live the culture.  As a leader, make it a point to walk around the office every day and thank people for their contributions.

Remember, changing culture is a process, not a task.  Even successful change efforts can be messy and full of surprises.  Keep nurturing your plan by using these four tips for communicating your new culture. By shaping your culture, you will have one more “unknown” to address.

Sharon Bock, Director of Marketing


Collections Policy, Part 3: Creating a collections culture

Once your policy is in place, you must develop a “collections culture” that values great customer service and efficient collections of AR – and makes both things a priority! Creating a collections culture means having a consistent vision and knowing how you’d like everyone to view your company. This means your staff must know to explain the patient’s financial responsibility and be comfortable asking for a payment.

If you are asking your staff to take on new tasks, start with small goals. Focus on one area, such as collecting payment info. For example, you can establish the goal for every employee to collect payment information from every patient. Track the activity and reward the employees who collect required information. This way you will reward the desired behavior and will reinforce good habits. Simple incentives such as gift cards, movie passes, or even a pizza party can reap big rewards!

When it comes to leading your team, Allegiance Group suggests using both “push” and “pull” strategies. Need a refresher on push-vs- pull leadership strategies? This article provides four opposed, but complementary, coaching examples.

Don’t be deterred by one method over the other. Choose which is best for your team and move forward confidently. If you’re unsure about your best leadership strategy, our team can help talk you through these options… whether you’re a client or not! Please reach out to Bruce Gehring at 913-338-4790 x202 to talk through more strategies you can try to influence change in your company.

“Pushing” your team to change their habits

  • Weekly review of intake team numbers. Celebrate winners. We like Fridays!
  • Rewrite job descriptions to include specifics
  • Set an aggressive short-term goal for team leaders

“Pulling” your team to be mindful of a collections culture

  • Build a collections graph to track the % of co-insurance that your team collects
  • Create mutually shared values and guiding principles together
  • Appreciate the work and the individual
  • Coach employees who are not embracing change
  • Recognize activities that reinforce your culture
  • Outline a simple rewards program for your team. We like these 52 ideas from Insperity!

No matter if you push or pull, changes will only happen if you make the commitment to analyze the efforts and data that come from the team’s effort.  If you’re the director of change, the best place to start is with yourself. Many billing software programs track who enters information into the system.  If one of your employees is not reaching his/her goals, have a coaching process in place to help.

Don’t forget about your patients!

Once your internal team is confident in what they’re doing and why it’s important, you’ll need to focus on changing patient expectations. In the past, many companies did not worry about collecting the patient balance until after the insurance portion was paid. Today, it is more common for providers to ask for payment upfront, so patients are becoming more accustom to paying their share before the service is provided.

What if the patient gets upset when you ask for payment?

Lay out a plan to explain to your patients why you’ve made any changes. Train your employees to be empathetic to your patient’s concerns.  This will help reduce the frustration level of your patient and allow them to compassionately set up a payment plan.

Five things you can do to help change your patient’s expectations:

1. Make sure your employees can clearly explain how much the patient owes for the equipment that’s recommended. This includes using your billing software or up-to-date deductible, co-pay and co-insurance coverage information to calculate the patient’s balance.
2. Communicate payment schedules to the patient from the first conversation – even if you don’t yet have a full estimate of benefits. Let them know that payment is due upon service and if there will be any additional bills over time in their case. It doesn’t have to be extraordinarily detailed – but repetition and transparency are important.
3. Post signs that say “Payment is due at the time service is provided.”
4. Get payment information as soon as you can. Make sure you can store the information securely – you can use a payment portal or software, like COLLECTPlus, to store the information early in the order delivery process.
5. Offer a variety of payment options, including payment plans. Some companies now even accept PayPal 😊

Want to learn more?

Read Jeremy Bloom’s article, 6 Steps for Creating a Strong Company Culture, for ideas you can include in your company culture to create a thriving business.