Tip: One take on how to classify self-pay patients

The segmenting process is always a work in progress, but it follows a few patterns, says Lester Poris, CPAM, the organization's manager of credit and collections. Here are three patterns and Poris' strategy for managing the challenges:

1. When a parent receives a statement, he or she calls customer service, which can take payment over the phone. Otherwise, customer service representatives tell parents where to send the check or they discuss payment plan options with the stipulation that the balance must be paid within six months.

"If the balance was large, and the parent can only send, say, $25 on a $3,000 bill, we tell them they have to [pay] the balance in six months," Poris says. "If they say they can't, we'll ask for financial data to attempt to set up a reasonable payment plan. If we can't, the account goes to the collection agency."

2. Parents often come to the hospital or schedule an appointment with a clinic and tell registration staff they don't have insurance. Children's uses two outside agencies to help parents get Medicaid, if eligible. Both agencies have staff on site who will meet with parents and go through the application process.

3. Children's also uses a financial assistance profile to determine charity care eligibility. The application process, which goes through customer service, uses the Federal Poverty Guidelines as a benchmark. If a parent's income falls within 250% of the guidelines, he or she could be eligible for charity, but would first have to be ineligible for medical assistance and financially unable to set up payment arrangements.