Be Mindful of Outsourcing Road Blocks Your Health Care Clients Face

Healthcare providers need to outsource now more than ever before.  For decades the merits of outsourcing have been debated; it will save money, it will reduce staff, it will bring us technology we can’t afford.  While you, the collection agency can see the positive side of outsourcing your hospital client may not be as receptive because they see the other side – this will cost money, I will lose staff, another system to learn.

To better serve your hospital clients keep in mind some of the issues on their side of outsourcing.

IT – We sometimes fail to realize how outsourcing will affect IT on the hospital side.  Depending on the hospital system and its’ limitations your outsourcing project may be tied up in IT for longer than you think.  Hospitals need, among other things, to set up an “internal agency “on their system in order to refer accounts and information to your agency.  This can be a time consuming process especially if they have never outsourced before and have no prior mapping.

The timing of accounts being sent to you will need to be adjusted within the providers system to meet all requirements including the “120-day” rule for Medicare reimbursement.  The hospital will also need to examine the timing of their bill drops to insure that patients are not getting a collection notice from you the day after they receive a statement from their hospital or doctor.  In many cases, accounts will also have additional wait time to comply with a third party contractual which will delay a referral to you.

Two Systems – When accounts are outsourced, the work environment becomes a two-system environment. Accounts will be on the hospital system and your agency system. If real-time technology is not in place, any work you complete on the account (i.e., payments, notes, repayment arrangements) will need to be relayed to the hospital system. Many times this means a daily or weekly file to transfer information between you and the hospital so everyone has the same detail.  You should keep this in mind when working with your hospital clients as well.  Depending on the timing of that information exchange, they may not have the same information on an account that you have.

The same is true for posting of payments.  The agency must have the correct amount of the debt so if a patient walks a payment into the hospital you must make arrangements to receive a daily payment file so your staff can update the individual accounts that are on your system with the correct amounts.  This can be particularly frustrating especially if a patient receives one amount from the hospital and another amount from the agency.

Again, limitations of the collection system may cause other issues for instance, if you are not able to “link” or connect accounts for the same patient or guarantor information you put into the system may only appear on an initial or master account. Any additional accounts for the same guarantor many not contain all the note files and you will miss important details relevant to that debtors’ account.

Customer Service – It’s easy to see how IT issues alone may affect customer service for your client as well. They, in most cases, will receive the first complaints from their debtors if your agency is unable to relay correct information to them.  You certainly do not want to receive complaint calls from your client for operational items you should have addressed before you began working their accounts.

With so many things to consider you can see why some healthcare facilities may hesitate to outsource.  It is up to you to work through the issues for each client and make sure your system and collectors are set-up to work your healthcare client’s accounts properly.

Shelly Haggard is the VP Sales & Marketing at Receivable Recovery Partners, LLC and Outsource Billing Services, LLC in Indianapolis, where she oversees business development and retention.  RRP has earned the top ranking among small companies in insideARM.com’s Best Places to Work in Collections for two years running.  Shelly can be reached via email at shelly@rrpllc.com.