At the Margins

Point-of-service collections start with you: 4 ways to get your staff on board

“This isn’t what I signed up for.”

In my work helping organizations improve their front-end collections, I hear this phrase a lot.

I get it. Most employees come to a hospital to help patients. They often feel they didn’t sign up to collect money, and many staff haven’t had adequate training to do so. What’s more, no one wants to upset patients or drive them away.

And yet, I’ve seen the best of the best help their staff do more than just tolerate asking for point-of-service collections. How do they get their teams excited about this effort? Here are four strategies I’ve found that are keys to optimizing your up-front collections:

1. Hardwire a culture around up-front collections—from the top down

First and foremost, it’s essential to establish a hardwired culture around upfront collections. Point of service collections is not optional—it’s the new standard. That message needs to come from the top down, “We are going to start collecting at the point of service. We’re going to ask every patient, every time.”

Next, it’s critical to align your processes and policies to back up your message. Set an organizational goal and then set managers’ and staff’s goals accordingly. Update key job descriptions to ensure point of service collections language is included. Consider updating performance review grids to include POS collections performance criteria. Make whatever updates you need to ensure that everyone is on board.

Optimizing Front Office Performance

Lastly, organizations doing this well have a formal accountability structure, so ensure everyone involved in the point of service collections initiative understands how their role contributes to the organization’s success, set measurable targets for each key staff member involved, and hardwire routine report outs on progress to-date against goals—across individuals, departments, and organization-wide.

2. Focus on education

Let’s face it: asking a patient for money can be uncomfortable. But with training, even the most timid registration staff member can master this skill. Train your staff to think about the discussion around point-of-service collections as more than just collecting payment. It’s about educating the patient, explaining what their benefits are, and what payment options they have. To boost staff confidence, give your employees a sample script to guide these types of conversations and educate them on the different types of patient out-of-pocket obligations (copay vs. co-insurance, deductible, out-of-pocket max, etc.).

3 ways to help patients navigate the care cost maze

Once your staff feels empowered to address these point-of-service collections head on, your patients be better educated about their financial responsibility, and increased up-front revenue capture will follow.

3. Plan your community outreach

Once you’ve got your organization fully on board, it’s time to think about how best advertise the point-of-service collections initiative within your community. Take the time to decide the most appropriate way to announce your new policies to ensure you set patient expectations. Then, think through how best to market your new policies to focus on the positive aspects of up front collections.

Lastly, consider the patient’s perspective—would you want to be surprised with a collection attempt on your date of service, or would you prefer to know your out-of-pocket obligation ahead of time? The majority of patients prefer the latter whenever possible, so consider pre-registration strategies, such as outbound calls 3-5 days prior to service, to further get the word out.

4. Remember the benefit to the patient

Price shopping is growing rapidly as we move into an era of increased price transparency. If you can provide a timely, accurate estimate to patients, you’re well prepared for price sensitive patients. There’s something else that we all can relate to—nothing kicks you when you’re down quite like a surprisingly large bill.

Overcoming the patient pay problem requires patient engagement

By sharing an estimate at the point of service, your patients have a reasonable idea of what they can expect to pay, before they even receive care. Even more, they can sit down with a financial counselor to arrange an ideal payment plan prior to service if they anticipate difficulty in paying the full amount at once.

Giving your patients those options should make you feel better, not worse, about the care you provide.

That, after all, is what you signed up for.

Ready to jump start your point-of-service collections?

Contact Adam Rosenberg at to learn more about how Payment Navigation Compass can help you improve your point-of-service collections.

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