Criteria for Determining Successful Partnerships between Healthcare Providers and Outsourced Collection Services

How do you measure the success of your partnership with a healthcare provider? Of course, increased recovery and improved collection rates represent primary metrics. But, what other important capabilities enhance the partnership?

Some critical evaluation criteria for provider-agency partnerships include:

  • Specific Experience in Healthcare Collections — Unless a provider selects an agency with substantial experience and a solid track record in healthcare collections, the partnership can be doomed from the get-go. An agency must understand the industry, as well as gain insight into how a healthcare provider organization works. Not only is a provider’s financial well-being at stake, but also its reputation.
  • Relevant Service Offerings – The services an outsourced agency delivers must align with market and provider requirements. An agency’s services will address the nuances of specific practice types. If an agency fails to meet the particular service requirements of a healthcare provider, no other criteria matters.
  • Regulatory Compliance Expertise – The healthcare industry must conform to a wide variety of regulations, including those required by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA establishes national standards for protecting a patient’s medical records and other personal health information. This requirement extends to all the vendors working with a healthcare provider, including collection agencies. Agencies must ensure the proper privacy safeguards remain in place during the entire collection process.

In addition, healthcare collections agency must adhere to the standards established by the Fair Debt Collection Practices Act (FDCPA) and the Fair Credit Reporting Act (FCRA). Both regulations dictate what a collection agency can and cannot do when attempting to collect a debt. FDCPA identifies how and when an agency can contact a patient, who they can contact about a patient’s debts and what practices are off-limits for collection agencies. FCRA covers the allowed parameters for reporting account status to the credit bureaus.

  • Understanding of Industry and Provider Standards – The right partner will fully grasp the internal collection principles established by a healthcare provider. In addition, ACA International, the association of credit and collection professionals, developed a code of ethics with which all outside organizations used to assist in debt collection should comply.
  • Professional Delivery of Customer Service – Third-party agencies need to provide details on how they manage the collection process. For example, how do you contact patients? How do you train and monitor agents? How do you handle early out collections? What practices do you avoid? What technology is used to enhance the collection process? Providing answers to these types of questions will distinguish the most professional agencies from the rest and will demonstrate the ability to meet patient needs.
  • Open Communication Channels – Accomplished agencies keep in touch with their healthcare provider clients on a regular basis. Adhering to a formal communication process helps you identify and resolve issues in a timely manner.

A successful partnership with a healthcare provider depends on meeting a wide range of requirements. Be sure to proactively offer detailed answers to the typical questions of healthcare organizations. After all, the profitability and reputation of your healthcare provider clients depend on your performance.

Ready to learn more about healthcare payment collections? View our latest on-demand webinar, “Quicker Wins for Early Out Healthcare Receivables,” now available here.