Webinar Recording - Medical Debt Collection with Compassion
January 16, 2020
Transcript - Medical Debt Collection with Compassion
Thanks, everyone, for joining our webinar, “Medical Debt Collection with Compassion – Are You Ready?”
We know your time is valuable, we look forward to sharing our knowledge and insight into the revenue cycle.
I’m Julie Boots, Client Relations Executive at the Credit Service Company. I’ll be your host today.
CSC has been in the full-service medical collections business for over 70 years. We’re locally owned and operated in Colorado Springs, Colorado. And our leadership team has almost 200 years of combined medical collections experience.
Did you know that at least 68% of patients with medical bills less than $500 do not pay off the full balance?
That’s according to the most recent data collected by TransUnion Healthcare. The 2017 study also predicts that by 2020, the percentage of patients who will fail to pay their bills in full will rise to 95%.
As high-deductible health plans and other increases in out-of-pocket spending are presenting challenges to medical providers, it’s becoming increasingly important that we maintain a compassionate approach to collecting money owed by your patients.
And that’s what we’ll be discussing today. Joining us is Andy Williamson. Andy is the Director of Client Services at CSC. He has over eight years of experience in medical debt recovery and shares our passion for ethics, compliance and client satisfaction.
Well, Julie, I know without a doubt that you and the rest of CSC team shares the same passions. Over 10 years ago I worked with a different collection agency and I know collection agencies may say the same things, but I found CSC is different in what we do.
Debt collection with compassion may seem like a contradiction. But let me share with you a couple of stories that illustrate how a compassionate approach actually recovers more debt.
One of our collectors had a patient on the phone. She was a young girl who owed about $1,000 for a bill that was the result of a domestic violence situation.
She was ready to pay the balance in full.
In light of the situation, elevated emotions and our philosophy “Do What Is Right,” our collector aided her in working with victim’s compensation.
At the end of it, she did not press charges against her spouse and was not eligible to collect any compensation. But she did express her appreciation for our collector’s approach. He was working for account resolution and doing the right thing.
We want all our collectors to listen, so they can “diagnose before they prescribe.” This requires them to think more objectively.
Andy, that’s a wonderful story. Do you know any others?
On a different note, something that happens many times a day:
A consumer answered a call from one of our collectors. He said he’d gone through a significant health event and was expecting our call.
In preparation for the call he took out a home equity loan and was ready to pay.
However, he wanted to see if the provider would now be able to reduce the amount owed.
Our collector sent a hardship letter to our Client Service Team. The healthcare provider reviewed the situation and was able to discount the balance.
It’s been our experience that consumers want to pay. They simply need a compassionate ear and an opportunity to work out payment arrangements.
Andy, I guess there are a lot of different ways to handle a collection issue.
There sure are; CSC owners Dave and Tracey Cannella take a lot of pride in handling potentially difficult situations with compassion.
According to Dave, they’ve “made a conscious decision to be the kind of company that tries to integrate compassion into the day-to-day business of collecting money.”
I believe they’ve done it.
Our collection specialists are never scripted. They’re trained to conduct compassionate discussions, using positive communication with all our consumers. When a client reaches out to see what is going on with a specific account, I’m confident that things were handled in a professional and ethical way.
The collectors always strive for resolution, which may not always be in a payment. There may be a contractual adjustment that was missed, or it was paid prior being sent to our office, possibly just a timing issue. Many times, just taking the time to sort out the dispute is all it takes to gain their trust and realize that the money is indeed owed.
Andy, can you tell our audience how they do this?
Absolutely, Julie.
One thing we do is account scoring.
Account scoring helps us to evaluate, internally, our collection efforts.
This helps us determine the amount of effort we place on phone calls, letters, and skip tracing. This, in turn, provides us with a careful balance, ensuring the greatest return on our effort on behalf of our clients.
Once accounts are listed, we have a series of vendors we utilize for identifying bankruptcy and deceased patients. Updated demographics allow communication with those who may not know about the existing debt.
Part of our scoring model for accounts gives us a charity score for each account. We can then work with your office to help qualify a certain population for charity assistance. Qualified consumer accounts would then be returned to the client for compassionate relief resolution.
In my experience with this industry, there are not many companies who invest in a compliance department, but at CSC we understand the importance of protecting ourselves, our clients and our consumers.
Andy, would you explain in more detail CSC’s approach to compliance?
Many times, accounts are unpaid due to a consumer’s confusion with insurance. We have a dedicated team to promptly assist with disputes and work with the consumers to help resolve these disputes.
First, we review patient intake paperwork, signed financials and the workflow prior to listing the accounts.
Our Professional Practice Management System holds us accountable through auditing, workflow management, risk assessment, employee monitoring, and call monitoring – including review for tone and compassion.
We teach how using negative words like “no,” “I can’t,” “you have to,” activates the sympathetic nervous system -- the “fight or flight” mode. We focus on using the more positive words in order to activate the parasympathetic system -- the “rest and digest” mode, so they’re more willing to work with us for resolution. Some options are, “Yes”, “We will Look Into that for you”, “what I Can Do”,
Credit reporting is a tool we use in the hope that a consumer’s situation will change over time.
Andy, can you describe the special program CSC has designed for consumers regarding credit reporting?
CSC has developed a Responsible Credit Reporting System. When a consumer agrees to a reasonable payment arrangement and keeps that arrangement, we’ll keep the account from reporting to the credit bureaus. Credit reporting is a very costly and time consuming process. We go the extra mile to have every dispute researched and responded to in a timely manner.
Andy, can you tell us a little more about CSC’s personalized service?
Right from the start, we ensure the details of the consumers’ accounts are available for the collector, while maintaining the minimal amount of Protected Health Information. We can assist with the export file layout and we offer several secure means of file transfers.
Consumer information accuracy is key to addressing and educating consumers’ questions and concerns at first contact, and avoiding unnecessary delays in the collection process.
Our reporting identifies accounts turned over too quickly, small balances not appropriate for collections, or Medicaid accounts.
We have an open line of communication with our clients, including regularly scheduled conference calls, personal meetings, and emails.
Every client is assigned a Client Service Representative who is fully aware of the wants, needs, specific workflows and preferences of the individual client.
We also strive to maintain excellent rapport with the community.
Andy, can you speak more to that?
Our long-term relationships with our clients show we help maintain a positive community image for our clients. The clients that we serve are a good fit with our compassionate approach. This approach has created trusted business partnerships, allowing our clients to retain their consumers.
We offer training to our clients to help them understand what happens once an account is turned over to collections. We also share industry knowledge and payment negotiation skills.
Andy, would you share the next step for anyone interested in getting started with CSC?
Sure, Jules. We know that each provider has specific requests regarding internal processes and preferences. So first we’ll walk you through these steps to see if we are a good option. We can mirror what your current process is, so it doesn’t disrupt your normal course of business.
Then we’ll negotiate an agreeable and competitive contingency fee rate. Next, we’ll send a collection service agreement and Business Associate Agreement for review and signatures. We request a copy of our client's intake forms for compliance review and place them in a client folder for our records.
We’ll ask a series of questions regarding the client's preferences, sharing of team contact information, report options, communication preferences, account-resolution options such as settlements, insurance discovery or charity.
We would also want to schedule ongoing meetings in order to streamline processes, resolve any unforeseen issues, and just stay in contact.
Andy, what happens when I turn an account to collections?
Without being too granular, essentially the account is listed usually, electronically. The accounts will be approved and acknowledged by the assigned rep, they are making sure what came over was listed in our database correctly.
The account goes through a series of tactics looking for minor child accounts and other compliant components. Then the account goes through a waterfall of skip tracing vendors to search for possibilities of bankruptcy and deceased, updated demographics as well as scoring the accounts for the propensity to pay. This all happens within the first day. The next morning the initial letter will be sent, if appropriate.
The account is then placed in a new business work queue for the collector to work in a calling campaign. The accounts will then be assigned to a specific collector, each collector does work each other’s accounts.
Of course, depending on the client’s preference, the accounts are scheduled to report to the credit bureaus to report at 60 days from listing or 210 days form the date of service, whichever is greatest.
We’ve developed conscious communication for our collectors. It is obviously applicable when negotiating any payment arrangements. We begin with asking for balance in full, we negotiate down from there, by referencing in time frames rather than dollar amounts. We find most consumers would rather resolve their accounts sooner than to pay for a long time.
During this process, the feel - felt - found technique positions us to be on their side during the call. Sound something like; I understand you feel.. I felt that way when… What I found is…
Depending on the score, the demographics, the account will be called continuously on different intervals. The calls, letters, and C/Reporting will be a gentle tap on the consumers shoulders reminding them of their financial obligation to our client.
A small percentage of our accounts qualify for litigation. We have internal criteria that we use to qualify accounts for this process, which is only used when we have determined there is an ability to pay but the consumer chooses not to. This is always our last option for resolution.
Let’s see what questions we have from our audience.
How much do you charge your clients to collect?
What would your office consider a competitive medical recovery rate?
How many of your clients do you collect for are in the healthcare industry?
How long would you recommend working a medical account prior to sending to collections?
Thank you very much for your time and attention.
Please feel free to reach out with any additional questions, and let us know if you are interested in becoming a valued CSC client.
We know your time is valuable, we look forward to sharing our knowledge and insight into the revenue cycle.
I’m Julie Boots, Client Relations Executive at the Credit Service Company. I’ll be your host today.
CSC has been in the full-service medical collections business for over 70 years. We’re locally owned and operated in Colorado Springs, Colorado. And our leadership team has almost 200 years of combined medical collections experience.
Did you know that at least 68% of patients with medical bills less than $500 do not pay off the full balance?
That’s according to the most recent data collected by TransUnion Healthcare. The 2017 study also predicts that by 2020, the percentage of patients who will fail to pay their bills in full will rise to 95%.
As high-deductible health plans and other increases in out-of-pocket spending are presenting challenges to medical providers, it’s becoming increasingly important that we maintain a compassionate approach to collecting money owed by your patients.
And that’s what we’ll be discussing today. Joining us is Andy Williamson. Andy is the Director of Client Services at CSC. He has over eight years of experience in medical debt recovery and shares our passion for ethics, compliance and client satisfaction.
Well, Julie, I know without a doubt that you and the rest of CSC team shares the same passions. Over 10 years ago I worked with a different collection agency and I know collection agencies may say the same things, but I found CSC is different in what we do.
Debt collection with compassion may seem like a contradiction. But let me share with you a couple of stories that illustrate how a compassionate approach actually recovers more debt.
One of our collectors had a patient on the phone. She was a young girl who owed about $1,000 for a bill that was the result of a domestic violence situation.
She was ready to pay the balance in full.
In light of the situation, elevated emotions and our philosophy “Do What Is Right,” our collector aided her in working with victim’s compensation.
At the end of it, she did not press charges against her spouse and was not eligible to collect any compensation. But she did express her appreciation for our collector’s approach. He was working for account resolution and doing the right thing.
We want all our collectors to listen, so they can “diagnose before they prescribe.” This requires them to think more objectively.
Andy, that’s a wonderful story. Do you know any others?
On a different note, something that happens many times a day:
A consumer answered a call from one of our collectors. He said he’d gone through a significant health event and was expecting our call.
In preparation for the call he took out a home equity loan and was ready to pay.
However, he wanted to see if the provider would now be able to reduce the amount owed.
Our collector sent a hardship letter to our Client Service Team. The healthcare provider reviewed the situation and was able to discount the balance.
It’s been our experience that consumers want to pay. They simply need a compassionate ear and an opportunity to work out payment arrangements.
Andy, I guess there are a lot of different ways to handle a collection issue.
There sure are; CSC owners Dave and Tracey Cannella take a lot of pride in handling potentially difficult situations with compassion.
According to Dave, they’ve “made a conscious decision to be the kind of company that tries to integrate compassion into the day-to-day business of collecting money.”
I believe they’ve done it.
Our collection specialists are never scripted. They’re trained to conduct compassionate discussions, using positive communication with all our consumers. When a client reaches out to see what is going on with a specific account, I’m confident that things were handled in a professional and ethical way.
The collectors always strive for resolution, which may not always be in a payment. There may be a contractual adjustment that was missed, or it was paid prior being sent to our office, possibly just a timing issue. Many times, just taking the time to sort out the dispute is all it takes to gain their trust and realize that the money is indeed owed.
Andy, can you tell our audience how they do this?
Absolutely, Julie.
One thing we do is account scoring.
Account scoring helps us to evaluate, internally, our collection efforts.
This helps us determine the amount of effort we place on phone calls, letters, and skip tracing. This, in turn, provides us with a careful balance, ensuring the greatest return on our effort on behalf of our clients.
Once accounts are listed, we have a series of vendors we utilize for identifying bankruptcy and deceased patients. Updated demographics allow communication with those who may not know about the existing debt.
Part of our scoring model for accounts gives us a charity score for each account. We can then work with your office to help qualify a certain population for charity assistance. Qualified consumer accounts would then be returned to the client for compassionate relief resolution.
In my experience with this industry, there are not many companies who invest in a compliance department, but at CSC we understand the importance of protecting ourselves, our clients and our consumers.
Andy, would you explain in more detail CSC’s approach to compliance?
Many times, accounts are unpaid due to a consumer’s confusion with insurance. We have a dedicated team to promptly assist with disputes and work with the consumers to help resolve these disputes.
First, we review patient intake paperwork, signed financials and the workflow prior to listing the accounts.
Our Professional Practice Management System holds us accountable through auditing, workflow management, risk assessment, employee monitoring, and call monitoring – including review for tone and compassion.
We teach how using negative words like “no,” “I can’t,” “you have to,” activates the sympathetic nervous system -- the “fight or flight” mode. We focus on using the more positive words in order to activate the parasympathetic system -- the “rest and digest” mode, so they’re more willing to work with us for resolution. Some options are, “Yes”, “We will Look Into that for you”, “what I Can Do”,
Credit reporting is a tool we use in the hope that a consumer’s situation will change over time.
Andy, can you describe the special program CSC has designed for consumers regarding credit reporting?
CSC has developed a Responsible Credit Reporting System. When a consumer agrees to a reasonable payment arrangement and keeps that arrangement, we’ll keep the account from reporting to the credit bureaus. Credit reporting is a very costly and time consuming process. We go the extra mile to have every dispute researched and responded to in a timely manner.
Andy, can you tell us a little more about CSC’s personalized service?
Right from the start, we ensure the details of the consumers’ accounts are available for the collector, while maintaining the minimal amount of Protected Health Information. We can assist with the export file layout and we offer several secure means of file transfers.
Consumer information accuracy is key to addressing and educating consumers’ questions and concerns at first contact, and avoiding unnecessary delays in the collection process.
Our reporting identifies accounts turned over too quickly, small balances not appropriate for collections, or Medicaid accounts.
We have an open line of communication with our clients, including regularly scheduled conference calls, personal meetings, and emails.
Every client is assigned a Client Service Representative who is fully aware of the wants, needs, specific workflows and preferences of the individual client.
We also strive to maintain excellent rapport with the community.
Andy, can you speak more to that?
Our long-term relationships with our clients show we help maintain a positive community image for our clients. The clients that we serve are a good fit with our compassionate approach. This approach has created trusted business partnerships, allowing our clients to retain their consumers.
We offer training to our clients to help them understand what happens once an account is turned over to collections. We also share industry knowledge and payment negotiation skills.
Andy, would you share the next step for anyone interested in getting started with CSC?
Sure, Jules. We know that each provider has specific requests regarding internal processes and preferences. So first we’ll walk you through these steps to see if we are a good option. We can mirror what your current process is, so it doesn’t disrupt your normal course of business.
Then we’ll negotiate an agreeable and competitive contingency fee rate. Next, we’ll send a collection service agreement and Business Associate Agreement for review and signatures. We request a copy of our client's intake forms for compliance review and place them in a client folder for our records.
We’ll ask a series of questions regarding the client's preferences, sharing of team contact information, report options, communication preferences, account-resolution options such as settlements, insurance discovery or charity.
We would also want to schedule ongoing meetings in order to streamline processes, resolve any unforeseen issues, and just stay in contact.
Andy, what happens when I turn an account to collections?
Without being too granular, essentially the account is listed usually, electronically. The accounts will be approved and acknowledged by the assigned rep, they are making sure what came over was listed in our database correctly.
The account goes through a series of tactics looking for minor child accounts and other compliant components. Then the account goes through a waterfall of skip tracing vendors to search for possibilities of bankruptcy and deceased, updated demographics as well as scoring the accounts for the propensity to pay. This all happens within the first day. The next morning the initial letter will be sent, if appropriate.
The account is then placed in a new business work queue for the collector to work in a calling campaign. The accounts will then be assigned to a specific collector, each collector does work each other’s accounts.
Of course, depending on the client’s preference, the accounts are scheduled to report to the credit bureaus to report at 60 days from listing or 210 days form the date of service, whichever is greatest.
We’ve developed conscious communication for our collectors. It is obviously applicable when negotiating any payment arrangements. We begin with asking for balance in full, we negotiate down from there, by referencing in time frames rather than dollar amounts. We find most consumers would rather resolve their accounts sooner than to pay for a long time.
During this process, the feel - felt - found technique positions us to be on their side during the call. Sound something like; I understand you feel.. I felt that way when… What I found is…
Depending on the score, the demographics, the account will be called continuously on different intervals. The calls, letters, and C/Reporting will be a gentle tap on the consumers shoulders reminding them of their financial obligation to our client.
A small percentage of our accounts qualify for litigation. We have internal criteria that we use to qualify accounts for this process, which is only used when we have determined there is an ability to pay but the consumer chooses not to. This is always our last option for resolution.
Let’s see what questions we have from our audience.
How much do you charge your clients to collect?
- CSC works on a contingency basis, which means we only charge if money is recovered.
- The rate offering is based on several factors, such as volume of accounts, anticipated balance of accounts, demographics, age of accounts, and potential growth.
What would your office consider a competitive medical recovery rate?
- This success rate can be measured in so many ways, such as in a month batch, gross, net, 18 months.
- There are many factors that can affect this rate, such as balance of accounts, age at listing, demographic area where the services are provided, how much that account was worked prior to turning to collections, and the type of specialty provided.
How many of your clients do you collect for are in the healthcare industry?
- Over 95% of CSC’s clients are medical.
How long would you recommend working a medical account prior to sending to collections?
- 120 days is generally the norm.
- This allows for any disputes to be settled with their insurance, such as filing necessary appeals, it allows for your PR to remain intact, and to sometimes even discover insurance coverage that was not provided.
- Many times, the patients do not expect to receive several different bills from so many entities just from a single date of service. This does get confusing to them and gives your office the time needed to explain exactly what your individual bill is for.
- Does your office enter the legal phase of collections, and if so, what is the criteria and process?
- We do use the legal process, but always as a last resort.
- This process is used when we determine that the consumer can pay, but they are choosing not to.
- Rigorous criteria are used for identifying these accounts, including balance, good address for process service, assets on record, such as employment, property or a bank account
- Even with our large inventory, it is a very small percentage of accounts that our office pursues legally.
- Until a judgment is entered, the consumer has many options to work with our attorney and collection team. We still would allow for a payment arrangement, a pay stipulation, or other possible resolution.
Thank you very much for your time and attention.
Please feel free to reach out with any additional questions, and let us know if you are interested in becoming a valued CSC client.
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Credit Service Company, Inc.
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2150 Lelaray St.
Colorado Springs, CO 80909 P.O. Box 1120
Colorado Springs, CO 80901
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Any correspondence related to a dispute should be sent to:
Credit Service Company, Inc. PO Box 2247 Colorado Springs, CO 80901
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Credit Service Company, Inc.
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This communication is from a debt collector and is an attempt to collect a debt. Any information obtained will be used for that purpose.
Credit Service Company, Inc.
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