whiteboard to build automated self-pay collections, apsc ...€¦ · automation option #1- budget...

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Whiteboard to Build Automated

Self-Pay Collections, APSC Part 1

AUGUST 9, 2016

First things first…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 3

Whiteboard considerations…

• POP > Statement Tab

– Are you sending

your statements by

account, department,

or division your

system?

• Minimum Balance for

statements

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 4

Whiteboard considerations…

• POP > General Tab

– How are you

currently aging your

system?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 5

Whiteboard considerations…

• Remember only billed

vouchers will qualify for

Automated Selfpay

Collections

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 6

Whiteboard considerations…

Do you want to review

accounts before the

collection process

begins?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 7

Whiteboard considerations…

Do you change the Account

Types for accounts?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 9

Do you change the Account Types of accounts?

No! That’s ok – YOU DON’T HAVE TO!

If Yes! Your possibilities are

ENDLESS!

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 10

Sample Account Types

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 11

Account Type Maintenance (ATM)

Are you

holding

statements

for account

types?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 12

Just one workflow???

Possible workflows for Large

Balance accounts

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 14

Large Balance Workflows – Example #11. Initial Review (Manual)

2. Change Account Type – Pre-Collections

3. Collection Note – Pre-Collections

4. Collection Letter 1 (Wait 14 days, Ext Wait 28 days)

5. Review for Letter 2 (Manual)

6. Collection Letter 2 (Wait 14 days, Ext Wait 28 days)

7. Final Review (Manual)

8. Final Letter (Wait 10 days, Ext Wait 28 days)

9. Transfer to Collection Agency (weekly)

10. Adjust off to Collections

11. Change Account Type – Collections

12. Collection Note – Add Collection Agency note & inactivate Pre-Collection Note

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 15

Large Balance Workflow – Example #21. Change Account Type – Pre-Collections

2. Collection Note – Pre-Collections

3. Initial Review & First Collection Call (Manual)

4. Call Review Extension (Wait 27 days, no Ext Wait)

5. Second Collection Call (Manual)

6. Provider Review Report (Wait 7 days, no Ext Wait)

7. Provider Review (Manual)

8. Dismissal Letter (Wait 1 day, no Ext Wait)

9. Transfer to Collection Agency

10. Change Account Type – Collections

11. Collection Note – Collections and inactivate Pre-Collection Note

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 16

Large Balance Workflow – Example #31. Collection Note – Pre-Collections

2. Provider Review Report (Wait 1 days, no Ext Wait)

3. Collection Call (Manual)

4. Collection Letter 30 day (Wait 30days, Ext Wait 30 days)

5. Provider Review (Manual)

6. Transfer to Collection Agency

7. Collection Note – Collections and inactivate Pre-Collection Note

*** Note the client does not change the account type

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 17

How a Collection Agency is setup…

Possible workflows for Small

Balance accounts

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 19

Small Balance Transfer

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 20

Small Balance Workflow – Example #11. Change Account Type – Pre-Collections

2. Collection Note – Pre-Collections

3. Initial Review & First Collection Call (Manual)

4. Call Review Extension (Wait 27 days, no Ext Wait)

5. Second Collection Call (Manual)

6. Provider Review Report (Wait 7 days, no Ext Wait)

7. Provider Review (Manual)

8. Dismissal Letter (Wait 1 day, no Ext Wait)

9. Transfer to In-House Bad Debt Collection Carrier

10. Change Account Type – Collections

11. Collection Note – Collections and inactivate Pre-Collection Note

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 21

Small Balance Workflow – Example #21. Initial Review (Manual)

2. Overdue 60 day letter (Wait 30 days, Ext Wait 30 days)

3. Change Account Type - Delinquent

4. Collection Call (Manual)

5. Overdue 90 Day Letter (Wait 30days, Ext Wait 30 Day)

6. Change Account Type – Dr Review

7. Provider Review (Manual ) *client generates an excel spreadsheet by provider for the report

8. Transfer to In-House Bad Debt Collection carrier

9. Change Account Type – Collections

10. Collection Note – Collections ***notice no Collection Notes are added until the account has

been turned over.

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 22

Small Balance Workflow – Example #3

1. Collection Note – Bad Debt (Balance range $.01 to $100.00)

2. Adjust Balance (using Bad Debt transaction code)

How do you want to handle

Budget Accounts?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 24

Budget possibilities…

Automation???

Handle Budget within

Existing Workflows???

2

1

OR

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 25

Automation option #1- Budget Workflow

1. Collection Note – Budget (Manual) ( qualified based on the user setting the

account type to Budget. Some clients use Payment Arrangements.)

2. Payment Plan Confirmation Letter (Wait 30 days, Ext Wait 30 days)

3. Missed Payment Letter (Wait 30 days, Ext Wait 30 days)

4. Provider Review (Manual ) *client generates an excel spreadsheet by

provider for the report

5. Transfer to Collection Agency

6. Change Account Type – Collections

7. Collection Note – Collections ***notice no Collection Notes are added until

the account has been turned over.

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 26

Automation option #2 - Budget Workflow

1. Collection Note – Budget (Manual) ( qualified based on the user setting the

account type to Budget. Some clients use Payment Arrangements.)

2. Budget Letter (Wait 30 days, Ext Wait 30 days)

3. Review (Manual)

4. Transfer to Collection Agency

5. Change Account Type – Collections

6. Collection Note – Collections and inactivate Budget Note

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 27

How to Handle Budget within Existing Workflows…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 28

Handling ‘Budgets’ within Existing Workflows

*Create a ‘Budget’ Action that can

be used independently of an

existing workflow’s defined actions

that serves as a placeholder in a

Collector’s queue to manage

Budget Payments

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 29

Handling ‘Budgets’ within Existing Workflows

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 30

Handling ‘Budgets’ within Existing Workflows

Other automation

possibilities…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 32

Bankruptcy Workflow – Example #1

1. Collection Note - Bankruptcy ( qualified

based on the user setting the account type to

Bankruptcy)

2. Adjust Balance (using Bankruptcy Adjustment

Code)

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 33

Bankruptcy Workflow – Example #2

1. Collection Note - Bankruptcy (

qualified based on the user setting the

account type to Bankruptcy)

2. Hold for Bankruptcy Approval Notice

(Wait 30 days, no Ext Wait)

3. Adjust Balance (using Bankruptcy

Adjustment Code)

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 34

Sample of Bad Address Workflow

1. Collection Note – Bad Address ( qualified

based on the user setting the account type to

Bad Address)

2. Transfer to Collection Agency

3. Change Account Type – Collections

4. Collection Note – Collections and do not

inactivate Bad Address Note since we still do

not have a valid address on file.

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 35

Sample of Deceased Workflow

1. Collection Note – Deceased Note ( qualified based on the user setting the account

type to Deceased)

2. Review for Death Certificate (Manual)

3. Death Certificate Hold (Wait 30 days, no Ext Wait)

4. Review for Death Certificate (Manual)

5. * User to add note when Death Certificate has been received in previous step

6. Adjust Balance (using Bad Debt Deceased transaction code)

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 36

Sample of Payroll Deduction Workflow

1. Payroll Deduction Note ( qualified based on the user setting the account type

to Payroll Deduction)

2. Payment Deduction letter (Wait 30 days, Ext Wait 30 Days)

3. Review

*** if the employee is no longer employed, they will change the account type to

standard and complete the account out of Payroll Deduction to be collected.

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 37

Sample of Homeless Workflow

1. Collection Note – Homeless ( qualified based on the user setting the account

type to Homeless)

2. Adjust Balance (using Bad Debt Homeless Adjustment Code)

Can we automate when an

account is Paid in Full?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 39

Action(s) to take when self-pay balance is paid in FULL!

There are two methods of exporting

accounts to an agency…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 41

Options for exporting accounts

• Standard export

–Contains the information in the current

Collection Account Report

–Will create two files: patient demographic

information and financial information

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 42

Options for exporting accounts

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 43

All the pieces of the puzzle…

AAM AWM WQM WOM

What is the gateway to

Automated Collections?

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 45

Work Queue Maintenance

Let’s tie everything together…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 47

Workflow Organization Maintenance

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 48

Distribution of accounts…

Copyright © 2016 Allscripts Healthcare Solutions, Inc. 49

Questions?

49

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