BJC Hospital POS Collections Overview
July 22, 2014
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BJC POS Collections Program - Goals and Objectives
• Goals
– Financial Improvement - expanded POS collection program will result in increased
patient collections, decreased Free Care and reduced vendor collection costs
– Enhance Patient Experience - improved communication prior to and at point of
service through notification of financial responsibilities and discussion of payment
resolution options
• Objectives
– Develop and Implement Collections Operating Model that will lay the leading
practice foundation to support the ability to ‘Ask’ patients for and to accept
payments
– Optimize POS Collection workflow from Scheduling through Point of Service
– Enhance Technology and Reporting to drive accountability and sustainability
– Program will NOT focus on Service Deferral or Denial activities
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BJC POS Collections – St. Louis Hospital Provider Market
Provider
Market % 1
POS
Insured
Uninsured
SSM Health Care
22.00%
Yes
No
No
Mercy
13.50%
Yes
No
No
SLU/Tenet Health System
5.75%
Yes
No
Yes - 20% upfront
St. Anthony’s
6.50%
Yes
No
Yes – no set amt
St. Luke’s
3.80%
Yes
No
No
Imaging Centers are
collecting at POS but
only deferring services if
an uninsured patient is
not able to pay
St. Louis area
hospital providers
are collecting at
POS but not
deferring services
if patient is not
able to pay
Elective Deferral?
Provider
POS
Elective Deferral?
Insured
Uninsured
Metro Imaging
Yes
No
Yes – 100% upfront
Watson Imaging Center
Yes
No
Yes – 50% upfront
Professional Imaging
Yes
Yes – $ 125
Yes – 50% preferred
The Imaging Center (IL)
Yes
No
Yes – 50% preferred
Sources:
1. St. Louis Healthcare Industry Overview 2013, St. Louis Area Business Health Coalition (2014)
2. Provider specific collections data obtained through Huron market analysis and contacts at provider facilities
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BJC POS Collections - Activities Update
Future State Operating Model – Finalized proposed service area roll-out, workflow,
scope, and approach in partnership with Patient Access and Rev Cycle Leadership
teams. Obtained approval from hospital Revenue Cycle Steering group.
Collections Communications – In partnership with Rev Cycle Leadership, presented
initiative to BJC Department Leaders, Physician Liaisons, Compliance, Marketing,
WUSM Business Directors, and other key partners to POS program
Training Plan and Reporting Solution – Developed curriculum to support POS
collections training and reporting in partnership with Patient Access and Training team
POS Vendor Tool Selection – Completed contracting with Recondo POS Estimation
tool. Kick-off and Technical Set-up timelines in process.
WUSM Clinic Follow-up– Completed shadowing activities at WUSM clinics (GYN and
Orthopedics) to understand current collections practices
Pre-Implementation Activities – Completed activities (i.e., training materials,
technology updates) in preparation for implementation phase
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BJC POS Implementation Approach and Timeline
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POS Collections – Primary Services Facility Roll-Out Timeline
• Upcoming POS Go-Live Dates: BJH, 7/23 and SLCH, 8/13
• Implementations consist of Training, Go-Live and Transition weeks
Implementation Timeline by Week
Facility
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
9/8
9/15
9/22
9/29
10/6
10/13
10/20
Radiology and OP Surgery
BJH
Radiology, OP Surgery
Cardiology
SLCH
Radiology and OP Surgery
PHC
MBSH
Radiology and OP Surgery
Pre-Arrival Center
Radiology and OP Surgery
MBMC
Radiology and OP Surgery
BJSP
Radiology and OP Surgery
PWHC
Radiology and OP Surgery
CH / NHC
Radiology and OP Surgery
Radiology and OP Surgery
AMH
Radiology, OP Surgery
Cardiology
BHC
BJWC
TBD - Radiology and OP Surgery
Huron Led and BJC Shadowing
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Huron Led
BJC Led
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BJC POS Future State – Key Operating Model Highlights
•
Workflow - Pre-Arrival and POS Registration Areas will work in collaboration to
attempt patient collection and accept payments.
•
Collection Amounts
•
•
–
A Standard ‘Ask’ Collection amount will be utilized during primary phase roll-out to allow staff to
focus on building a strong foundation on how to ask for and accept payments
–
Using data driven approach to develop standard amounts (e.g. $100) by high level service (e.g.
MRI, CT, Surgery) that will be consistent across facilities and limit credit balances
Payer Scope
–
Collection activities will include Managed Care, Medicaid, and Uninsured patients
–
Exclusions will apply to traditional Medicare, dual coverage, workers’ compensation, auto
insurance, and Veteran’s Administration due to difficulty in upfront estimate determination
Payment Processing
–
–
All collections areas will utilize Payment Navigator Tool to process payments and accept
credit/debit card and check as forms of payment
Cash will be accepted at Point of Service based on meeting all required security protocols and
logistical requirements (i.e., lockbox) as well as defined reconciliation and cash handling
procedure produced by Security Audit department
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BJC POS Training and Education Plan
People
Process
Tools
Documentation Guidelines
Worklist Updates
Soarian/SMS Updates
Scripting/Role-Playing
Standard Ask Guidelines
Payment Navigator
POS Collections Overview
Security Measures
New Credit Card Machines
Quality Review
Payment Handling
Goal Setting
Super User Preparation
Financial Assistance Options
Reporting
Change Management
Payment Options
• Training Approach
– Live classroom training sessions as well as on-line modules for all Pre-Arrival and Registration
Staff
– Super-users will be identified at each facility to provide continued support and sustainability
– POS Collections training will be incorporated into Patient Access staff new hire training
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What Questions to You Have?
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