Jason Kaufman, RN, director of emergency services at 320-bed St. Francis Hospital in Indianapolis, explains how the hospital improved collections from ED patients.
1. Make sure there is a conversation. In a busy ED, where clinical care comes first, it's easy to forget asking a patient for payment, but it becomes much more difficult to collect a copayment or the full bill if the hospital waits until the patient goes home.
2. Understand federal law. The EMTALA law forbids asking for money from ED patients before a "screening exam" is performed. At St. Francis, the screening exam is thought of as the physician's examination, so collection is not made until the patient is discharged. However, some EDs ask for money earlier in the process and St. Francis is examining that approach.
3. Install ATMs in the ED. Having a nearby source for patients to obtain funds makes it more likely they will pay their bills. The collections rate at St. Francis' three EDs increased when ATMs were installed there.
4. Walk patient to the collections office. After treatment, an ED nurse should walk patients to the collections office. Since a long walk is waste of the RN's time, St. Francis moved a financial counselor close to the ED. This step increased the percentage of patients who talk to the counselor. St. Francis will have the same arrangement when it opens a replacement ED for two other hospitals next year.
Learn more about St. Francis Hospital.
Read more ways to improve hospital profitability:
- 8 Strategic Thoughts and Concepts for Hospital Leadership: Developing a Strategic Plan and Allocating Hospital Resources
- 6 Ways to Improve Efficiency of Hospital-Employed Physicians
- Monitoring Your Hospital's Revenue Cycle: Six Metrics to Review Each Month
1. Make sure there is a conversation. In a busy ED, where clinical care comes first, it's easy to forget asking a patient for payment, but it becomes much more difficult to collect a copayment or the full bill if the hospital waits until the patient goes home.
2. Understand federal law. The EMTALA law forbids asking for money from ED patients before a "screening exam" is performed. At St. Francis, the screening exam is thought of as the physician's examination, so collection is not made until the patient is discharged. However, some EDs ask for money earlier in the process and St. Francis is examining that approach.
3. Install ATMs in the ED. Having a nearby source for patients to obtain funds makes it more likely they will pay their bills. The collections rate at St. Francis' three EDs increased when ATMs were installed there.
4. Walk patient to the collections office. After treatment, an ED nurse should walk patients to the collections office. Since a long walk is waste of the RN's time, St. Francis moved a financial counselor close to the ED. This step increased the percentage of patients who talk to the counselor. St. Francis will have the same arrangement when it opens a replacement ED for two other hospitals next year.
Learn more about St. Francis Hospital.
Read more ways to improve hospital profitability:
- 8 Strategic Thoughts and Concepts for Hospital Leadership: Developing a Strategic Plan and Allocating Hospital Resources
- 6 Ways to Improve Efficiency of Hospital-Employed Physicians
- Monitoring Your Hospital's Revenue Cycle: Six Metrics to Review Each Month