Staff work as a financial team and increase the up-front payments

With all its staff – front desk, billing, and clinical – working as a financial team, a North Little Rock, AR, surgery practice has increased its pre-surgery payments by 25 percent.

“It’s not rocket science,” says Linda Atkins, manager of Neurological Surgery Associates. “It’s just common-sense things.” Every staffer “looks at the money picture” and has a role in it, she says, noting that “they understand that if we don’t collect, we don’t get paid.”

The process starts as soon as a surgery is scheduled. At that point, Atkins and the nurse evaluate the insurance.

From there, the nurse and biller identify the likely CPT codes.

Then the biller finds out the copayment amount, where the patient stands on the deductible, and what the patient’s out-of-pocket expense will be. The outcome, Atkins says, is that patients know they have a responsibility, know what that responsibility is, and know it ahead of time.

Patients are required to pay a week before surgery. If the amount is large, the office collects half up front and at the same time sets up a payment schedule, usually for no more than 12 months.

The front desk staffer is the gatekeeper. She copies the insurance card, makes sure the information is correct and complete, and runs the eligibility checks. For Medicaid patients, she verifies the number of allowed visits remaining. She also collects the copay.

The exit desk staffer verifies that the copay has been paid. If not – and that can happen when someone is filling in at the front desk during lunch – she collects it before the patient leaves.

Tying up the picture are the three billers.

There are three surgeons, so each biller focuses on the work for one doctor. That way, when there’s a question about a patient’s payment, everybody knows where to go for help.

The billers also serve as financial counselors, which gives each patient a single contact person. They explain the financial picture to the patients, collect payments, set up payment plans, and help some patients get whatever additional coverage is available.

With the total staff participation, every financial item is taken care of before the surgery.

Rarely do patients complain about all the up-front financial work, Atkins says. But when they do, she explains the necessity of it. Mostly, it’s a matter of telling them that if the office doesn’t get the payment straightened out ahead of time, they could find out too late that the coverage isn’t what was expected and end up being personally responsible for the cost.