Group Therapy at NAHAM: Collections, Denials, and Training Top List of Challenges

Group Therapy at NAHAM: Collections, Denials, and Training Top List of Challenges

At NAHAM 2019, peers got together during a Group Therapy session—presented by Megan Ford, Patient Access Director, Colquitt Regional Medical Center and Lance Mills, Vice President at Pelitas—to share ideas to solve their most complex challenges. While the problems facing healthcare today are numerous, the group focused on three: Collections, Denials, and Training. Patient Access leaders from various parts of the country shared what’s been working for them and, as the title of the session suggests, commiserated with each other, recognizing we are all facing common issues and not alone. Here are some of the highlights from the session:


Collections: Do Staff Incentives work?

All organizations have a need to increase pre-service collections, but many struggle. While they may be aware of the idea of incentives, they’re unsure how to implement them. Will it turn their registration staff into brutish debt collectors? Will patient satisfaction suffer? How can they convince their superiors to allocate funds to pay out on these incentives? Luckily, a Patient Access Director with first-hand experience implementing an incentive program was at the Group Therapy session.

According to this Patient Access Director, since implementing the incentives program, patient experience has actually improved, team morale couldn’t be higher, and allocating resources for the incentive program is a non-issue given the increase in collections. The program is quite simple: Registration staff have a quarterly collections goal. If they get 100% of that goal, they get a $500 bonus. If they hit 120% of that goal, they get an additional $500 bonus. This means the staff are able to supplement their annual income by up to $4,000! The staff love it. The patients actually expect to pay at registration and like the experience of dealing with one registration staff member rather than getting multiple phone calls and bills to collect payment.

The program also ties the bonus back to accuracy in registration data. An accuracy element focuses the staff on quality and cash. This has an effect on preventing denials down the road, which we’ll discuss later on in this blog.

When asked how they convinced their superiors to implement the incentives program, the Patient Access Director said it was a non-issue. If the goals and incentives are thought our properly, it just makes good business sense to pay a little in order to collect a lot more. Add to that the possibility of increased patient satisfaction, improved team morale and employee retention, and a reduction in denials… it’s a no brainer!

Denials: Accuracy is the answer

With the increased complexity in healthcare coding, value-based contracts, higher deductibles and more self-pay customers, write-offs from denied claims is rising. Denial prevention is paramount and starts as soon as the patient interacts with your hospital. The moment they schedule an appointment, fill out a form, or hand over an insurance card is the moment to focus on accuracy.

But how do you monitor for accuracy and what other actions can you take to improve it? During the session many ideas came to light, but namely these two which go hand in hand:

First, you need an automated accuracy tool with a rules-based engine allowing 100% review of accounts, not just those over a certain dollar amount. Accuracy tools like iPAS from Pelitas also have automated real-time alerts so staff can fix errors before they impact cash flow and other revenue cycle processes.

Second, you need to utilize the information you glean from the accuracy tool to identify opportunities for education and training. If your staff is making the same mistake over and over again, you need to figure out why and fix that issue through the proper training. One attendee to the session mentioned that staff should be automatically directed to training if they make the same mistake three times. We love this idea, but even a manual approach is a great start to specific training based on registration errors.

Training: Finding the Time and Resources

Group Therapy session attendees were from predominantly larger organizations with dedicated trainers and educators. How best to utilize that team—on-site or remote, for example—was discussed briefly. All great ideas, but we were really interested in how smaller facilities with very little extra resources (both time and money) can provide training for their staff. We all agreed that the more training staff has, the better off the organization will be. For example, in the two sections above your staff would need to be trained on how best to collect payment at registration and how they can improve registration accuracy. It’s clear that training is a necessity no matter your organization size, but how do you fit it in when your time and money is already stretched so thin? You tell us.

We’re throwing up the bat signal! Are you from a smaller facility with ideas on how best to train and educate your staff? Please reach out to us and share!


This Group Therapy session was a great representation of what NAHAM 2019 was all about… Leaders coming together to help each other and shape the future of patient access. Let’s keep this Group Therapy session going. Keep sharing ideas and challenges and helping out your peers. Leave a comment or reach out to me directly at