Enclosed you will find HIPAA Business Associate Agreement and Third Party
Collection Services Business Associate Agreement.
All documents were prepared by our Attorney, Dave Hamilton. Dave Hamilton is
HIPAA certified and I am sure you will find these agreements meet all the
necessary requirements.
If you have any questions please contact CSB at
801-621-4411 or 1-800-453-2416 and request to speak with a representative.
Enclosed you will find HIPAA Business Associate Agreement and Third Party
Collection Services Business Associate Agreement.
All documents were prepared by our Attorney, Dave Hamilton. Dave Hamilton is
HIPAA certified and I am sure you will find these agreements meet all the
necessary requirements.
If you have any questions please contact CSB at
801-621-4411 or 1-800-453-2416 and request to speak with a representative.
Suggested Collection Verbage Suggestions from Attorney David Hamilton
Contract Language for Collection Fee
The undersigned specifically agrees to pay all reasonable attorney's fees and
court costs in the event legal action is taken to collect on the account. The
undersigned further agrees to pay an additional amount representing 50% of the
principal balance if the account is referred to a collection agency or attorney
for collection. This additional amount is in recongnition of the costs
associated with said collection action processing.
Collection Services Bureau of Utah, Ogden, Utah 84401, (801)
621-4411
Copyright 2007, All Rights Reserved
National healthcare spending has grown at an average annual rate of 5% since
1993. The rate is expected to increase to 6.5% between 1998-2001. Between
2002-2007 the expected rate of increase is 7.5%.
By 2007, healthcare spending is expected to top $2 trillion.
The average American family spends $2003 out-of-pocket per year on health
related services.
83% of Americans believe that they will have problems accessing and affording
medical care in the next few years.
In 1997, healthcare systems reported $6.2 billion in bad debt, up from $5.6
billion in 1996.
In 1998 there were 41.7 million uninsured Americans, or 15.6% of the
population.
Getting Credit Information
How can you, the professional healthcare provider, improve your return on
receivables and help ensure that your practice continues to be profitable?
By following the simple procedures outlined here, you will be able to collect
more of your accounts receivable.
It is important to remember that an estimated 85 percent of all out-of-pocket
medical services are paid for through credit arrangements. This makes you a
credit grantor much like department stores, oil companies, utilities and
others.
You differ, however, from most other credit grantors in at least two ways:
In most cases, your customer would rather not have to use your service. And,
in some instances, patients do not have a choice of products, services or brand
names, nor can they make price comparisons.
Although you may have treated an injury or illness and made the patient feel
better, there usually isnt anything tangible, such as a car or television set,
to be a reminder of your care.
When it comes time for your patients to pay their various bills, yours is often
on the bottom of the pile. You find that you are competing with other credit
grantors that supply a more tangible product, and your collection problem is
therefore more difficult.
This is why its important to learn as much as possible about your patient and
to make your credit policies clear before the service is actually provided,
when the patient is likely to be the most cooperative.
When patients come to your office, your receptionist or secretary should have
them fill out a simple patient information form. The information provided by
the patient on the information form will prove critical to your billing and
collection efforts. Your admitting personnel should be trained to obtain this
information before admitting the patient for treatment.
The information should include:
Patients full name and birth date.
The full name of the person financially responsible for the account, his or her
street address, telephone number and the number of years that he or she has
lived at that address.
The Social Security Number and drivers license number of the person
responsible for the account.
The responsible persons previous street address and the number of years he or
she lived there.
The responsible persons present employer, the number of years he or she worked
there, his or her job position or title, the name of the supervisor and the
employers address and telephone number.
The address of the responsible persons previous employer and the number of
years he or she worked there.
The name, address and telephone number of the nearest relative not living with
the responsible person and his or her relationship to the person.
The name and address of the party that referred patient.
The name and address of the patient or responsible persons insurance company.
Also verify insurance information at this time and record any necessary
details, such as group or individual account numbers.
Its a good idea to explain the credit and payment policies of the office
before services are performed. You may want to inform the patient/responsible
person that the healthcare provider is not responsible for obtaining payment
from the insurance company. Although the healthcare provider may file a claim
as a courtesy to the patient, obtaining payment from the insurance company is
actually a matter between the patient and the insurance company and is
therefore the responsibility of the patient.
Some offices give patients a form that explains the payment policies and
clearly states that the patient/responsible party will be required to pay all
amounts not paid by the insurance company. Some patient information forms
require the patient/responsible party to sign and date a statement that he or
she agrees to these conditions. Some offices have a receptionist or secretary
explain the basics of the office credit policy to each patient.
Predicting Potential Collection Problems
Here are some of the situations to look fort that will help you predict a
potential collection problem and alert you to the high-risk accounts you should
watch carefully:
Has the patient/responsible person worked several jobs in a short period of
time? People who change jobs frequently are often poor credit risks.
Has the patient/responsible person moved often? Changes of address may be an
indication of instability. The patient may be more likely to try to skip out
of the bill by not notifying you of his or her change of address.
Is the patient undergoing personal problems? People who are separated or
recently divorced and those with repeated illnesses in the family may have
trouble making payments.
If any of these signals appear on the form, you will do both yourself and the
patient a service by discussing the situation openly. Naturally, you will want
to make allowances for hardship cases. Most patients want to pay their bills
and are relieved when you help them set up a payment schedule.
Collection Schedule
Speed and regularity are the keys to successful billing and collection
procedures.
The average past-due account depreciates rapidly unless effective communication
is maintained between the creditor and debtor at all times. Since time becomes
a refuge for the debtor looking for a reason to put off payment or not to pay
at all, it is important to set up a fast, effective collection procedure.
The following billing and collection schedule, which has worked well for
professional credit grantors, is recommended:
Ask for payment at the time of the treatment, if possible. Some providers offer
a cash discount for payment at the time of service. This is an excellent way to
improve cash flow. You must be careful, however, not to violate government
health plan or health maintenance organization rules by offering such a
discount or making an up-front payment request. If asking for payment in full
at the time of service is not possible, an alternative is to calculate the
portion of the bill that will not be covered by insurance and ask the patient
to pay that self-pay portion at the time of service.
Furnish an itemized statement within 30 days after treatment. The best results
are obtained by presenting the statement at the time of treatment or by mailing
it between the 10th and 20th of the month.
Send a second statement 30 days later.
Mail a short, courteous collection letter 15 days after the second statement if
no payment has been received.
Make a courteous telephone call 10 days after the collection letter is sent.
If the phone call is ignored, send a final letter stating that the account is
being placed with a collection specialist.
What Next?
There is a limit to the amount of time and effort that you should expend
attempting to collect a past-due account internally. That limit has been
reached when you have lost effective contact with your patient.
Further collection efforts on your part most likely will be unsuccessful if any
of the following conditions apply:
Failure to respond to your statements, letters or phone calls.
A lapse in payment arrangements for no valid reason.
Repeated complaints.
Denial of responsibility.
The patient moves and does not give you the new address.
Indication of serious marital difficulties.
Repeated changes in address and occupation.
If any of your patients with past-due accounts fit into these categories, it is
time to refer the account to your collection specialist. Your collector knows
how to recover your money while maintaining the patients respect and
confidence in you.
Dont delay the longer an account remains unpaid, the more difficult it is to
collect.
Should You Do It Yourself?
Some health professionals and hospitals feel that they can collect past-due
accounts more profitably themselves. They want to save the fee charged by a
collection service.
Here are some of the costs involved if you decide to do your own collecting:
Salaries In addition to the salary of the collector, you should include the
time you will need to spend supervising the collection operations.
Rent Although it may be just a corner in your office, required space should
be figured at the standard rental rate for space in your area. You are giving
up space that you may need for expansion or that you might release and rent to
someone else.
Utilities Include heat, light and water among your costs.
Telephones There are installation costs and increased monthly bills.
Postage Your collection operation will require increased postage for the
mailing of collection letters and statements.
Computers, software and other office equipment This involves a big initial
investment, and it depreciates quickly. Your accountant can figure the
depreciation on the equipment you will need for your collection service.
Additional personnel costs The cost of recruiting and training employees and
of lost production during training periods should be included when you are
figuring costs, as should the cost of employee benefits. Hiring and retaining
skilled collectors is becoming increasingly difficult.
Accounting costs You will need monthly and annual financial statements.
Possible loss of public image By trying to perform the complete collection
function yourself, you may risk increased liability and possible damage to your
public image. Unless your staff is thoroughly trained in everything from
consumer debt counseling to state and federal credit and collection laws, the
potential exists to mishandle accounts and possibly lose future patients.
Loss through lower recovery percentage Figure the cost to you if your
collection ratio is less than it might be if you used a collection specialist.
Your collection ratio must be at least equal to that of an outside collector in
your area who is collecting accounts similar to yours. Also, the cost of doing
your own collecting should be less than the percentage fee charged by the
specialist. Otherwise, you have gained nothing. If your costs exceed the
collectors fee, you have lost money.
Another option would be to outsource or contract out certain billing and
collection functions. Out-patient, self-pay receivables is just one area where
an outside service can assist you. Firms that offer early-out or accelerated
receivable management programs have the technology and trained staff to work
these accounts much faster and cheaper than provider personnel. In addition, by
outsourcing those functions, provider staff can concentrate more effectively on
high balance accounts and other productive areas.
If you need to supplement your cash flow, healthcare receivable funding
programs provide a line of credit and give up-front money for procedures
covered by insurance.
Selecting a Collector
We are members of ACA International, the Association of Credit and Collection
Professionals. ACA is an international trade organization of credit and
collection professionals who provide a variety of accounts receivable
management services. Headquartered in the United States, Canada and 55 other
countries worldwide.
ACA has approximately 5,200 members including third-party collection agencies,
credit grantors, attorneys and vender affiliates. Members agree to comply with
all applicable laws and regulations, as well as the ethical standards and
guidelines established by the association. For more information, ACAs Web site
is located on-line at
www.acainternational.org/.
ACA members also have access to extensive education programs that keep them
up-to-date on federal laws relating to credit and collections and on the latest
professional collection techniques.
Most collection services work on a contingency basis, meaning that if they
collect, they earn a fee from the money collected. If they do not collect,
there is no charge to you for their efforts. Some ACA members offer other types
of compensation plans. We will be happy to answer any questions you may have
regarding fee arrangements.
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
healthcare providers are now required to have contracts with all business
associates who have access to patient information. Collection agencies are
considered to be business associates under the HIPAA definitions. Please be
assured that as a member of ACA, we have access to a wide variety of
educational material and resources regarding HIPAA and its impact on the
healthcare receivables industry, including information on crafting business
associate contracts under HIPAA. Although HIPAA has changed the way that
providers and collection agencies exchange information, we are certain that we
can continue to provide high-quality, effective receivables services within the
framework of the HIPAA regulations.
We offer a complete professional collection service within our geographic trade
area. In addition, we are able to forward accounts to another area, in
situations where your debtor has moved, by using the annual ACA Roster that
lists the approximately 5,300 member offices.
Through our membership in ACA, we can offer a variety of services and resources
to help you manage your receivables, including education, information about
collection laws, and public relations and legislative programs and materials.
In addition to general collection industry resources, ACA has also developed
the Healthcare Services Program (HSP). Created in 1984, HSP has a long history
of providing ACA members with information, education and services addressing
the specific needs of healthcare collectors. Through us, many of these services
and resources are available to you.
Working Together
We hope that you will refer future accounts to us. When you do, there are some
things you can do to make our relationship mutually profitable and effective:
When a patient calls you as the result of a collectors efforts, refer the
patient back to the collector to make payment arrangements.
If a payment is made to you directly on an account referred to us, let us know
immediately. This will enable us to keep our records up-to-date and ensure that
your patient is given credit for the payment. Also, if we are unaware of direct
payments, we could be accused of harassment under the federal Fair Debt
Collection Practices Act (FDCPA) when we continue to contact the patient for
payment. We are, of course, entitled to a full fee even if the payment is made
directly to you, since we have done the job that you asked us to do.
Requests for frequent progress reports impede rather than enhance collection
productivity. Though we will do our best to keep you updated on the status of
your accounts, it is to your advantage to limit requests to specific needs.
This will permit us to bring the collection of your accounts to a speedy
conclusion. We are as anxious to collect as you are to have us collect, since
that is how we earn our fees.
We will remit to you at least once every 30 days unless you make some other
arrangement with us.
If you request it, we will return accounts to you. If, however, we have been
successful in setting up a payment schedule or in partially collecting an
account, we will expect to be reasonably compensated for the work we have done.
We are your representative and want to work closely with you. If you have any
questions about our services, feel free to discuss them with us.
As a healthcare provider and professional credit grantor, you have an
obligation to your patients and to yourself to grant credit wisely, to obtain
the necessary information about the patients to whom you are granting credit
and to make sure that those who are able to pay their bills do so. By setting
up credit granting, billing and collection policies and procedures and by
recognizing that time is the safest refuge of any debtor you are well on your
way toward fulfilling this obligation. We hope these ideas will help you
accomplish this goal.
When the time comes for you to turn your delinquent accounts over to a
collection specialist, you can be assured that our office, a member of the ACA
International, will give you the finest possible collection service.
Collection Services Bureau of Utah, Ogden, Utah 84401, (801)
621-4411
Copyright 2007, All Rights Reserved
American
Collector Association
