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Q: How do you organize which collectors handle which accounts?

Patient Financial Services Weekly Advisor, July 23, 2004

A: We have our collectors matched to certain payer groups-usually two people assigned to a group with an alphabetical split between them. For example, I have two people working all Blue Cross and CIGNA. They get to be experts in the ins and outs of the payers and provide valuable feedback that we take to our monthly payer meetings.

Their workload volumes are customized to their payers, depending on how difficult (time consuming) it is to follow up with the payer. If a payer has electronic claims status with deductibles/copays and clearly understandable reason codes online and the electronic service is reliable, they can work many more accounts than the commercial indemnity collectors who have to pick up the phone for every call. This is figured into their number of assigned accounts. This also dictates how soon accounts qualify to them.

The workload is divided into four dollar splits: high dollars, mid dollars, low dollars, and recurring accounts. Each work list is separate so I can control how often these accounts qualify. If they are doing a bang-up job, I can escalate qualification where it is most needed. If they are behind, I can delay a work list as needed to ensure that the number qualifying is workable.

I can't stress enough the importance of ensuring that the number qualifying for follow-up each week is actually workable. Otherwise, they will never cycle the A/R completely or adequately.

If your system has the ability to see how many days it has been since the last activity, this is very valuable information. I routinely (at least twice a month) run reports to see what is falling through the cracks. This report helps me know whether there is a bottleneck and where. It also allows me to put extra resources on any accounts that fell through. If I see a trend with a specific payer, I look to see if both collectors assigned to the payer are being impacted or only one-thus the reason for the alpha split within the payer group.

I've used this method for 15 years and it has resulted in best practice numbers every time. I'm sure it isn't the only way to skin the cat, but it is effective.

This question was answered by Sue Davis, CPAM, manager, central business office at University Community Health in Tampa, FL.

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