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POM’s Solution for Hospital Results in Gross Revenue Increase
The POM business partner highlighted in this case study is a 950-bed healthcare provider serving five counties in the State of New York.
One of the Provider's major insurance carriers presented it with a renewal contract with unacceptable terms. The Provider rejected the contract, forcing it "Out of Network." Subsequently, all payments to the Provider were diverted directly to the insured/patient and paid at full charges. In order to be paid for care given, the Provider was challenged with finding a way to have patients send them payments they received from the carrier.
The POM Solution
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After one week of evaluating the Providers's potential risk, the POM team devised a solution designed to meet the challenge.
To mitigate the Provider's exposure, POM used its expertise and experience to create a customized plan that included:
- Messaging campaigns using predictive dialing and account representatives asking patients to remit their checks from the carrier to the Provider.
- Sending out postage-paid envelopes to enable the insured/patient to mail checks more easily.
- Using toll-free numbers in all communications to ensure each insured/patient would be routed directly to one of POM's experienced account representatives.
- Use of dynamic, automated systems to link POM with the carrier's remittance facility to determine when checks were being issued to patients.
POM’s telephone campaigns started when a patient was discharged and continued until the patient had sent their check or had set an appointment to have the check personally picked up. Once the check was mailed to the patient, POM moved the hospital’s account to its agency side, while still working under the provider's umbrella. POM account representatives contacted patients to coordinate pick up of checks or express mailing of checks directly to the provider's facility.
POM’s program for the Provider has generated, to date, a major increase in revenue. The program is still in existence. Through the success of POM’s program, results have exceeded the Provider's expectations for returns. In summary, this program has enabled the Provider to experience increased revenues, while maintaining their reputation for exceptional patient care.