Hospital Consulting

The Challenge

With the steady rise in consumer driven health care and high deductible health plans, hospitals are increasingly faced with the challenge of recovering a growing percentage of charges from self-pay patients rather than third-party payors.  Hospitals that fail to successfully revise or tailor their billing and collection practices for the self-paid will be forced to pay the price through a lower rate and speed of recovery, increased billing inquiries and reduced customer satisfaction.

While many hospitals have addressed the revenue cycle in general terms and with respect to institutional payors, few have undertaken the task of revising billing and collection communication practices to address the unique needs of the self-paid.  Our experience and research has shown us that most hospitals and revenue management consulting firms have difficulty assessing and improving communications with the self-pay since most of their experience is with third-party payors.  For decades, hospitals, insurers, states and the federal government have developed a common billing language and methodology, a language and methodology completely unfamiliar and baffling to even the most sophisticated self-pay patient.  This confusion, which usually starts at the admissions desk and is perpetuated through the billing and collections process, produces frustrated and skeptical patients.  These disgruntled patients significantly increase administrative costs by consuming valuable staff time to defend or explain bills and billing practices.  In addition, cash flow is impacted since payments are delayed or recovery is reduced simply because a patient misunderstands his or her financial obligations or is unwilling to pay a bill they do not understand.

The Missing Link

Since most revenue management programs tend to focus on only one half of the self-pay problem - processes and procedures such as frequency of invoicing or collection triggers - little attention is paid to the actual communication from a hospital to a self-pay patient.  With only part of the self-pay problem being addressed, hospitals are not capturing the full benefit of their revenue management programs.

For over a decade, Karis has served as a professional intermediary between hospitals and self-pay patients, helping hospitals and the self-paid better understand one another as they move towards a mutually acceptable resolution of outstanding bills.  Karis is well poised to leverage this experience and expertise to help hospitals substantially improve their communications with the self-pay patient and thereby extract the full potential of their revenue cycle management programs.  Recognizing a market need and lack of qualified firms to meet that need, Karis is launching a new hospital consulting service leveraging its knowledge and experience for the benefit of hospitals seeking to find the missing piece of the self-pay puzzle.

Our Objectives

• Implement HFMA Patient Billing and AHA Patient Communication Best Practices
• Clear, concise, correct and friendly communications
• Reduce billing inquiries
• Improve consistency and reduce redundancy of communications
• Manage payment expectations early
• Treat self-pay with dignity and respect
• Increase compliance with and completeness of documentation requested from patients
• Increase customer satisfaction
• Accurate invoices and statements with clear action points
• Quicker collections
• Reduce GDRO
• Reduce bad debt ratio

 

Our Consulting Process

In cooperation with key staff, Karis will engage in a three step (ARM) process to improve how a hospital communicates with self-pay patients:

• Assess current procedures and strategies;
• Recommend solutions and oversee implementation; and
• Measure results.