Eli's Rehab Report

Hint: Role playing can be a fun and effective technique.

Feel like your staff and therapists are getting rusty on collections and billing know-how? Here are some ways to spread critical cash-saving knowledge. "Collections training is very important, now more than ever," says Connie Treonze, administrator for an Orthopedics practice in Union, N.J. "The insurance companies [are] feverishly finding ways not to pay providers. If a staff member is not appealing and researching the denied claim, it will be a financial disaster for the practice."

"Collections in general, and good training, are so important now because of the economy," agrees Marge McQuade, CMSCS, CMM, a consultant and director of education for PAHCS in Florida.

For starters: "Enroll [your staff] in coding forums, subscribe to correct coding companies that can give them the necessary correct coding initiative (CCI) edits needed for appeals, and always have the current coding books for CPT, HCPCs, and ICD-9 at their disposal," Treonze recommends. Make sure you also access the payers'Web sites for their rules and specific guidelines in areas such as medical necessity, frequency, etc.

When a new (office staff) member starts in your practice, make sure you show her how to effectively capture payments from patients. "Our office has the new employee sit with one of the collectors the first day, taking notes and observing our collections protocol," Treonze says. "They are then moved into the actual collections process ... supervised by one of my seasoned employees."

"Without supervision, they tend to 'do their own thing,' which is usually the easy way out," Treonze stresses. "The job is very frustrating, so monitoring is very important. It is very easy for a person to get 'burnt out' dealing with insurance companies and patients."

You should also have regular training to refresh the skills of your current employees as well, McQuade says.

Critical: Refresher training should also include your therapists, as patients may bring up payment issues with them as well.

Finally, Treonze suggests monitoring your practice's -- and even individual collectors' -- collections success rates. "I monitor each one of my collectors with a weekly performance form that I have implemented," Treonze says.

In lieu of a prefabricated collections seminar, McQuade suggests conducting your training sessions in staff meetings or one-on-one with collection staff members.

Good idea: Role-play can be an effective training tool for new employees with no prior collections experience and for employees who may be nervous and unsure of themselves during collections attempts. Practicing sample scenarios also lets you gauge where people need practice. Then, when your staff goes live, have available collections scripts and small written reminders, McQuade suggests.

"We have scripts for the front office staff on how to ask for money and a very detailed pamphlet to give the patient that explains the billing process," says Meryl Freeman, MS, PT, manager of outpatient rehab for Rex Healthcare in Raleigh, N.C.

Tip: "In one office, I posted a note that said, 'How will you be paying for your co-pay today?' by the receptionist's desk because she kept forgetting to ask for the patient's co-pay, McQuade says.

When conducting collections training, make sure your therapists and office staff learn to avoid words and phrases like:

• Can you ...?

• Will you ...?

• Would you like to ...?

• Did you want to pay for that today ...?

• Did you want to discuss this with billing ...?

Instead: Tell your therapists and staff to use words and phrases like these:

• You'll need to pay for your balance today before you see the doctor.

• We require payment of your balance today.

• How will you be paying your balance today? Cash, check, or credit card?

• We can take a post-dated check. (Use as a last resort.)

• Co-pays are payable at the time of service per your contract with your insurance company.

• I would be glad to set up a payment plan for you.