build your edits on. Even a few good edits can have a huge
dollar impact on your organization.”
When It’s Time to Collect
Handing the mic over to Beyer, the presentation turned to
Sanford’s operations in customer service and collections.
Once more teaming with Experian Health, Sanford has for
the past four-and-a-half years utilized a series of collections optimization tools. Perhaps the most consequential
of these has been a unique screening program, which
cleanses the A/R and reduces the cost to collect by removing accounts that should not be targeted for collections. The
tool allows Beyer and his team to update addresses in the
face of returned mail, scrub for bankruptcies and patient
deaths Sanford may not have otherwise been aware of, and
determine potential patients that are eligible for charity or
By focusing on those patients who have a high likelihood
of paying, while at the same time leveraging financial assistance or charity for those who can’t, Sanford has successfully
increased its own internal recovery rates.
“We really anticipated that we would be sourcing less
accounts to our collection agencies,” says Beyer. “And we
certainly did do that. In the first year alone, we reduced our
accounts listed with our agencies by over 27%. And the agencies, themselves, improved their collections that first year. We
found out that by keeping the pipeline of bad accounts from
being sourced to them, it helped improve their collectability as
well. So it was a win-win for not only us but also our agencies.”
In addition to this segmentation of collections, Sanford’s
collaboration with Experian Health resulted in the launch and
utilization of its TCN phone system and dialer. Up until 2015,
Sanford’s four primary business offices—spread across Sioux
Falls, SD; Thief River Falls, MN; Bismarck, ND; and Fargo,
ND—were each on separate phone systems. Staff in the
Fargo region could only service patients in their own vicinity.
With the TCN’s cloud-based platform, however, every representative can now have the ability to take any phone call from
Leveraging the capabilities of the TCN platform even further, Sanford has implemented a new return mail campaign,
identifying discrepancies in patient addresses; has been able
to more efficiently reach out to patients to coordinate and
update payment plans; arranged financial assistance where it
is needed; provided coordination between patients and insurance carriers to understand benefits; identified and updated
expired credit cards; and worked to create ad hoc campaigns
that can draw from the system’s features and capabilities.
Ultimately, Sanford Health has achieved a substantial
return on investment since working with Experian Health in
regards to its collections efforts. Since 2014, Sanford has wit-
nessed an uplift of approximately $54 million in its self-paid
cash collections, with an average monthly lift of $1.3 million
(see Table 2).
“Our long-term success and continued growth is defined. As
my boss always said, ‘Cash is king,’” says Beyer. “Our collection lift is one of the key indicators of our success on the back
end. We’re continually strategizing. We work with our consultant from Experian to continually tweak and modify and look
for better ways and different ways to approach patients and
get them engaged in resolving those balances with us. It’s
been a great experience up to this point. It’s a great tool, and
we have a great set of individuals working with us to make
this happen all the way around.”
Michelle Rietschel, RHIT, is director of Coding, Training and Denials,
Provider Practice; and Mike Beyer is senior director of Patient
Accounts, both at Sanford Health.
With improved efficiency, Sanford is able to
place a greater strategic focus on its bill collection, dividing payers into five categories or
segments, each determined through data based
on patient behavior, credit score, and demographic information.
X Segment One is made up of patients who
generally pay every time they receive a state-
ment, and in most cases are paying balances
X Segment Two is made up of generally the same
promptly paying patients, but who typically
have higher balances or have a high-deductible
health plan. These patients can’t take care of
their bill in one payment, but are successful in
paying their statements over time.
X Segment Three is made up of those patients
with substantially higher balances, which
Sanford must pursue more aggressively with
alternative financial options or assistance
X Segment Four includes those patients with a
much lower propensity to pay, which Sanford
pursues in a limited capacity.
X Segment Five is made up of patients who have
the absolute lowest propensity to pay, and
highly qualify for financial assistance.