Top 5 Myths Of Early Out Self-Pay

There is a lot of information floating around about Early Out Self-Pay, an emerging healthcare service necessity, but as with many things, not all of it is based in fact.


As Vice President of HRG's OutPartnering™ Center and Executive Director of HRG's Early Out Self-Pay department prior to that, I can help you gain some clarity by debunking the Top 5 Myths Of Early Out Self-Pay that just don’t hold up in practice. 


Myth #1: Propensity-To-Pay Account Scoring Is Good

Fact: Propensity-to-pay has a place in a business office that is understaffed and has little time to perform true self-pay functions.  However, when hiring an Early Out Self-Pay vendor account scoring decreases the number of accounts a vendor will bother to work. At HRG we believe in working all accounts, because each account represents an opportunity to provide cash results for our clients. The scores do not adequately capture all of the life changes that occur and the motivating factors for a patient to make a medical payment.  As life circumstances change, a person with a low scoring could be willing and able to work toward account resolution and increased collections.

Account Scoring is Good – Debunked!

Myth #2: Hard Collections Work

Fact: Typically, patients will have decided within 30 seconds of a call whether they can or are willing to pay on an account. If an effective listening strategy is utilized, a self-pay representative may be able to identify alternative solutions such as charity care or an extended payment plan, based on the customer’s needs and circumstances. By listening effectively and offering solutions the reputation of facility is reinforced, thus leading to higher levels of perceived customer service and satisfaction.

Hard Collections Work – Debunked!

Myth #3: AR Days Are More Important Than Cash In Bank

Fact: Is it better to have $25,000 more in revenue or 5 less AR days? The line between what are considered ‘acceptable AR days’ and ‘acceptable cash collections’ gets somewhat sticky in this age-old debate. There is indeed a need for these metrics in healthcare but at times it can be pushed to the extreme. Liberalizing payment policies allow more patients to be on payment plans but also increases AR days. Loose adjustment policies may reduce AR but do not result in earned cash.  It’s a delicate balance and there should be give and take in either direction.

AR Days are More Important than Cash in the Bank – Debunked!

Myth #4: Bad Debt Is Better Than Charity

Fact: Bad debt is an unavoidable facet of healthcare revenue. It is true that there are advantages of bad debt on the cost report, but there are also tax exemption advantages for charity care.  The current economic climate, including factors such as 501®, has caused what might be perceived as a tightening of the regulations of charity care. Rather than trying to collect the uncollectible, offering expanded charity assistance can be an excellent community marketing tool. Putting in a good solid process that screens and offers charity care earlier in the process helps to decrease overall collection costs on the back-end. 

Bad Debt is Better than Charity – Debunked!

Myth #5: My Patients Would Never Use That Technology

Fact: Self-pay is an area of healthcare that is growing rapidly on the technology front. Text-to-pay, patient portal, recurring ACH payments and paperless bills are all emerging technology to assist patients with payments. Some facilities are wary of the new methods, much as the banking industry was unsure about ATM and debit cards initially. However, as is demonstrated by the astounding ATM and debit growth in banking: the future is new technology. There is an expectation by most patients that an option such as a web portal or an automated phone system be available for patients to make payments.  Some patients will even avoid making a payment if the only option is to talk to a live person. 

My Patients Would Never Use That Technology – Debunked!


Jason Coffin


Client care is the top priority for Jason Coffin, a Certified Revenue Cycle Expert (CRCE-1), CHFP.  Jason oversees all operations of HRG’s OutPartnering™ Center located in Spokane Valley, Washington and is responsible for Central Business Office (CBO), Extended Business Office (EBO), self-pay and quality assurance services.  He is focused on continuous improvement initiatives to ensure HRG remains the best choice for healthcare providers. Jason and his team provide outsourced revenue cycle services and support to hospitals and clinics throughout the country. 


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