Redefining Collections in Health Care Settings - Essay Example

According to Sutter Health, there are 47 million Americans who are uninsured but more than 80% of them have the capacity to pay some or all of their health care needs. The network, however, discovered that someone has to collect from these patients and that someone must have appropriate skills in order to do it effectively. For Sutter Health, the best time to collect from patients is before the service is provided, however, the network realized determined that there are problems to implementing this.

For example, registration staff who are the first point of contact are unaccustomed to ask for money so they allot this task to the back end office. On the other hand, back-end officers are unable to access patient information on demand so there is a delay time in the collection. To address this needs, Sutter Health instituted a new system that will allow its PFS staff to access real-time information about the provider’s collections performance, operational indicators, generate reports to the level of data they need, etc.

Potential problems such as incorrect information provided can be checked immediately, hence ensuring reduced denials of insurance claims. Through the new system, Sutter Health provided its staff with the right tools to make decisions based on individual cases that they handle. Moreover, outstanding accounts can be determined immediately, thereby allowing the PFS staff to prioritize cases for collection. This new system will also allow the staff to monitor his/her performance and enable the provider to offer additional compensation based on employee achievement.

All staff is required to undergo training. Training differs per staff area. For example, registration staff had to learn effective patient communications so that they can learn how to ask people for money. Meanwhile, back-end officers have to learn how to take ownership of the account assigned to them. Through this strategy, Sutter Health allows its employees to work effectively, they are able to make autonomous decisions in resolving problems as well as provide feedback to the administration on how to improve performance.

On the side of the patients, Sutter Health believes that such an approach is also advantageous because they get to have a ballpark figure of the amount they have to pay so that they can prepare for it. Moreover, patients who are unable to pay for their bills upfront can arrange special payment schemes to ease the financial burden.