Increase Revenue with ClearGage

Christine: I’m Christine Sharon, the marketing manager with ClearGage. We are welcoming you to our webinar, Maximizing Patient Collections. And today, this webinar will be hosted by Chip Hunziker, the CEO of ClearGage, and Jason Barnes, the chief operating officer of Genesis. Welcome, gentlemen.

Chip: That’s right.

Christine: Chip, I’m going to turn…pardon me. Chip, I’m gonna turn the meeting over to you to begin.

Chip: All right. Thank you very much, Christine. Thank you, Jason. We’re very excited about bringing you this presentation and we’re excited about our relationship with Genesis. So, let’s get started. What we’re gonna talk about today is how to maximize patient collections and why you, as a healthcare provider, really need to stop and minimize the leaky bucket around bad debt. We need to be able to collect our patient money cost effectively, we need to be able to offer our patients real financial solutions that’ll help them get the care they need, and help you increase your conversion ratio and your cash flow. Why technology and services, and why ClearGage is are unique to the market. And more importantly, how you could integrate these within practice management systems to make sure that you’re able to deliver the revenue generating machine, the ability to collect from patients and the ability to collect from your payers, all seamlessly on one platform.

So, why do we need to adopt a leaky bucket related to our healthcare collections? The reality is healthcare providers are one of the poorest businesses in terms of collecting patient receivables. The retail market has 3.5 % bad debt in healthcare. It’s 25% to 50% when it comes to patient collections. And the fastest growing segment of bad debt is patients with insurance, so it’s very important that we put these solutions in. And it’s no secret, as these patients leave your premises, and walk out the door and then we need to bill and chase them, what this slide shows is the cost of collecting your receivable. So, we know that the cheapest way to collect a paycheck receivable is your patient co-pays. You collect it right at the point of care. Oftentimes, you’re collecting it before you see the patient. Most times, you only have merchant account fees associated with it. So, point of care collections is by far the most cost effective. As that claim ages, as your patients walk out the door, and they receive your product or service and then you bill them 30, 60, 90 days, the cost of collections only grows.

So, one of the things that we recommend to all of our clients that every one of you who are healthcare providers should adopt right away is what we call card or account on file. Think about it. Hotels do it, car rental companies do it and now you can. And what we’re saying by card on file is you have the ability to capture your patients’ payment vehicle, either their credit, debit card or even their checking account, keep it in a PCI compliant, which means it’s masked, it’s encrypted so no one can use it for any unauthorized purpose, and you keep it on file. So, when your patients come in and they receive your product or service and they pay your co-pay, should they leave and you bill their insurance company only to find out that there’s a post insurance claim or liability, you can go ahead and automatically run that payment. And what does that do? Well, it transforms the payment cycle from where the patient comes in, they pay their co-pay, they see your doc, you create a claim, you drop the claim, whether you drop it. Hopefully, you’re doing electronic claim submission, but you drop the claim, you then wait for the claim to be adjudicated. Then you find out the patient has a balance, and you send a statement and you send a statement, and all of a sudden, you find out that 60, 90, 120 days has passed and your patients still owe you a balance.

Well, with our card on file process, what happens is the patient checks in, they give you their payment card, you store it, they give you the agreement and consent for you to store it, you create the claim in the same manner, you bill in the same manner. But instead of sending them a paper statement informing them that they owe you money, our system would actually send them a text or e-mail, and that text or e-mail would notify them that their payment is going to run. So, we would let them know how much money the patient owes and it would even be able to give them, solely up to you, maybe one day, two days, three days, four days worth of notice, letting the patient know if there’s a problem to contact your office, but you’re gonna run their payment for $63.

So, whether you use our system or not, here’s a little implementation checklist that you should have. So, first of all, when you’re setting up this program you wanna configure the program to make sure a majority of your patients who have a post insurance claim balance would be covered. So, what we tell our providers to do, if you’re a chiropractor and your average post insurance bill is $65, then what we would say is set your limit at $75, to $80, to $100, something reasonable that a patient would be comfortable allowing you to charge their credit card without them having to give you authorization at that time. In effect, they’re giving you prior authorization. And since I have a relationship with you, and I see you all the time and I allow you to treat me, I’m very comfortable with giving you authorization that says, ”if I come and see you and I authorize a product or service that you deliver, should I owe you money later, to find out 30 days later that I owe you a $100 or less, go ahead and run my card.” We’d let them know that we’re gonna give them a notice period. So, we’ll let you know that it’ll be one to two days after you’ve received a text or e-mail. So if there’s any problem, “Have you lost your card? Are you concerned about overdrafts?” call us and we will work with you to get another form of payment. Our system would easily automate refunds, and what we wanna let them know is, any charge, it will only be authorized by them and, of course, Visa, MasterCard, all of the payment vehicles have what’s called zero liability. You as their healthcare provider aren’t gonna charge them for a product or service that they aren’t going to owe, that they really don’t owe. And if you do, you will refund them the money. All of your patients should agree to that.

Our system generates a legally binding agreement. Very, very simple. It collects all the payment information. You can see here that it’s masked. So, for security purposes, no one sees the full digits. It lets them know what the terms are. They initial this. It’s stored in the system and then you never have to do anything. One of the things I wanna talk about it next to the card on file is one of the troubling things that we see in healthcare today with high deductibles and all of the different benefit plans that are out there, or if you’re a provider that’s offering weight loss and nutrition, or decompression, or any other products or services that aren’t covered by healthcare. The number one reason why patients aren’t getting the care that they need is the lack of financing. So, what we recommend to our providers is whether you do it or you understand it or not, you need to be able to provide financing solutions to your patients. And why is that? Because here’s what happens in chiropractic today. When a patient comes in they have two pain scales. One is their physical pain and their others their wallet pain. And chiropractic care works so good that the problem is, as the patient begins treatments, what you will see is their pain will immediately decrease. But what happens is, as they’re coming in and they’re seeing you every time, what happens is they begin to associate a trip to your office not as pain relief but as painful, because every time they come see you they have to reach in their wallet to pay you money.

What we recommend is that you set your patients up, you take your care plan, you let them know that they’re going to need the products and services to get the full benefit of your treatment. They might need 25, 30 visits, and you’re gonna put that in a package that allows the patients to pay for it over time. And the reason that you need to do this is chiropractic studies show that 50% of patients who seek chiropractic care will forego it or abbreviate it due to money. But if you can offer them an affordable payment plan that fits within their budget, their utilization is gonna increase nine times. And what does that mean? They’re gonna get the care that you prescribe, they’re gonna have better outcomes, and you’re going to increase your practice revenue along with your patient satisfaction. So, again, the number one thing you can do is offer a patient payment plan to your patients.

So, we wanna talk a little bit about some of the keys to a successful financed program. What do you have to know is you have to know your customer, you have to know their demographics. You have to know your costs. You have to understand that, if you’re offering a finance program and it’s an in-office program, what is the time value of money? You have to be able to embrace bad debt. That doesn’t mean that you should have bad debt that’s 20%, 30%, 40%, but if you’re setting up patient payment plans, you need to have policy and procedures that allow you to minimize patient bad debt. And you need to have the pricing and discount strategy that works for your practice. And above all else, you have to have a financing program that, at a minimum, covers any of your hard costs or fixed costs.

So, when we talk about know your customer, for those of you old enough to remember “The Beverly Hillbillies,” this was a whole joke about the fact that these people would come in and you didn’t realize that they were multimillionaires. Well, it’s true on both sides of the equation. You really need to understand your customer. Now, the ClearGage payment tool allows you to do a risk assessment or credit check on all of your patients with your patients’ consent. And the Federal Credit Board Agency allows you, as a healthcare provider to do this. It’s called permissible use. So, you can check your patients’ creditworthiness. Now, our program won’t affect a person’s FICO score and our program, when you’re offering someone a payment plan, meaning they want your product and service, they need help paying for it over time because they have a high deductible, you’re going to afford them the ability to pay for it, you can do a credit check. And why is it important to know your customers? Well, the customer’s credit rating will obviously impact whether or not you get paid, whether or not how much you get paid, and whether or not how much it’s going to cost you to get paid. So, again, there’s nothing wrong with offering a payment plan to a patient, there’s nothing wrong with extending them payment terms, but you wanna be able to know the patient and know whether or not they have the propensity to pay.

So, this is a poll that I wanted to ask you and that we’ll publish the results at the end, but do you agree with this comment? And the question is, should consumers cover the cost of financing and not providers? So, if a patient or consumer requests the ability to pay someone over time, who should cover the costs of that? Do you agree that it should be the consumer? Do you somewhat agree that it should be the consumer? Or you don’t agree? In this case, do you agree that the patient should cover the cost of financing and not you, the healthcare provider? And when we talk about costs, what’s important to know is, what are the hidden costs associated with provided financing? First of all, you or your people have to do the administration of the program. You can outsource that to a third party. We at ClearGage, we provide that service. There’s others that provide that service, but one way or another there’s a cost of administration. You also have the costs associated with the time value of money. And obviously, there are bad debt costs. And of course, if you choose to do financing with a third party, where that third party will give you a lump sum payment, there is the cost of discounts.

One of the things that we teach all of our providers to do is, if you’re going to offer patient payment plans, one of the number one things that you have to do is you have to have an ability to collect the down payment, and you have to stick to that. So, if I’m providing weight loss services, for example, and I’m providing a $1,500 treatment plan over six week,s and I’m going to give the person $350 worth of product, either detox supplies or certain nutritional supplements, and that patient is gonna walk out the door with that product that on day one, I may never see them again. What’s important is I collect the costs, my hard costs and my costs of my initial consult as a down payment. If patients can’t afford to put a down payment down, chances are they’re telling you they’re very high risk. So, always get a down payment.

I love this slide. This is a choice all of us would like to wrestle with, right? Whether or not, if you won the Lotto, in this case the Powerball, would you take a $425 million jackpot, would you have that paid over 20 years, collecting that over 20 years, or would you like a lump sum payment of $242 million? Now, again, it’s a nice choice to have, but what this shows is the time value of money. This person chose to get paid upfront, even though he got a discount, because it’s the time value of money. So, when you’re setting up a payment plan in your office and you have the opportunity to get paid upfront, what I wanna show you is how powerful that is to get the cash upfront. So first of all, by law, you are allowed, as a provider that is providing an installment loan to your consumer, depending upon the state that you reside in, you are allowed to collect interest. So, we don’t recommend you charge 25%, 30% and, frankly, most states wouldn’t allow you. But I’m from the state of Florida, and the state of Florida allows you to charge up to 18% interest. Now, why would you charge interest? Well, first of all, you’re providing a product and service to your patient, you’re incurring the cost of delivering that care upfront, and you’re allowing them to pay over the time, and you’re incurring the cost of money and bad debt. So, it’s reasonable that you would charge your person, in this case, maybe 11% interest. That’s commensurate with interest that a person would pay on their credit card, so certainly not user risk, and it allows you to provide this patient with a product and service and allow them to pay for it over time.

So, in this case, what you’re saying to the patient is, “Look, you could have given me $2,000 upfront, over two weeks, maybe, or three weeks, or paid upfront, but in this case you couldn’t do it. So, what I’m allowing you to do is pay me a down payment today, and I’m allowing you to pay me $185, $40, $45 a week, verses $40, $65 a visit. I’m allowing you to get the product or service you need today, to get the lifestyle that you want and I’m allowing you to pay me over time.” So, what would you rather do? And frankly, what could you rather do? And if you look at most consumers, most consumers today don’t have the ability to write a check for $2,000 over three weeks. And a lot of consumers, frankly, don’t have the available credit. So, you need to be able to offer them a payment plan within the office. So, based on this payment plan that you set up with the patient, at ClearGage you would have a choice. You would have a choice to get a lump sum payment upfront. So, based on a $2,300 payment plan, we would give you $1,990 in 10 business days while the patient pays you over 12 months. The advantage is you’re getting paid in 10 days what the lender or what the patient hopes to collect over 10 months. That’s the time value of money. And what that means is, because you’re getting a lump sum payment today versus waiting 12 months, if you had a 15% return on your money because you got a lump sum payment and you put it in a bank account or you put it in the stock market, that would be worth, at the end of 12 months, $2,135. So, in this case, for a variance of $102, you’re getting a lump sum payment upfront. You’re getting paid what you need to make money and your patient is getting the product or service.

So with our program, you have the ability, and whether you’re doing it in house or not, one of the things you need to be able to do to make sure you have the right tools in place, someone like Genesis practice management software integrate it with a company like ClearGage is gonna offer you a solution that allows you to be able to automate your payment plan, that allows you to reduce bad debt. With ClearGage, you have the choice of getting paid upfront all within your practice management system. So, again, one of the things that we say to our people is, “You have a choice. You can get paid upfront or collect your money over time.”

So, real quickly, just to let you know a little bit of why ClearGage is different. If you choose our program, 100& of your patients will qualify with immediate approvals. You have the choice to get paid upfront or collect your money over time. It’s up to you. You can self-administer your own program, meaning your staff do all of the work, you do all of the management of the patients. In that case, it’s wholly free to you except you have the cost of doing that. You can earn interest or set fees, or you can offer zero interest. And 100% of your patients can have a credit check that won’t impact their FICO score, so you know whether or not you can get paid. Now, Jason, thank you very much. I’m gonna turn it over to you to talk about how important and critical it is to have these solutions integrated with your practice management system. Jason?

Jason: Yeah. Well, thanks. I love it. And I just could not echo any louder the sentiment that you need to have these policies in place in order to run the practice that you want. I’ve talked to way too many doctors that want everything that you’re talking about, but it’s all about setting it up so that you can actually get it done. And so I don’t know how to be PCI compliant, Chip. I don’t know anything about it, frankly, and we don’t want to. We don’t know a lot of things about financial processing. We don’t understand how authorize.net works and we don’t want to. But the one thing that ClearGage doesn’t know is, when a balance hits $100, that you wanna automate the running of a card. And so we wanna help practices like yourself hook up with great services that have thought through what you need in your office, and then allow you to set those thresholds so that you can actually take advantage of that.

So, I’m just choosing share my screen right now. It should be happening. I’m really hoping that it is. I’ve got a lot of faith in the technology. So, when we get ourselves in a scenario where a practice puts policies and procedures in place like Chip was talking about, being that a patient walks through the door and you’re going to make it a policy that you’re gonna keep an account or card on file, you’re gonna get that disclosure signed. How are you going to make sure that that one gets done for every single patient? And that’s where Genesis comes in, and we can actually help you put in a consent that needs to be filled out for every single patient, so that you know that the patients that don’t have a task that opens up telling you, “Susie Smith is missing her consent for a card on file.” You’ll know whenever a new patient comes through the door and that’s not done. And that’s a part of our testing system, and this is the Genesis system where we’re gonna show you how to create these notifications that are gonna show up and give you an actual task that’s assigned to somebody, that says, “So-and-so is missing that notification.” Now, you have a report of findings. There’s a million things that need to be done. You need to set up the scheduling for the patient. You need to set up the multiple appointments that they need to show up for. You have to understand what their financial commitment is going to be. And how are you going to take that money? Chip, I’ve gotta tell you, I’ve stolen your slide or at least the idea for it, where the patient walks through the door in the beginning and they’re in so much pain, and they’d pay anything to get out of the pain. But after 10 visits, they’re out of pain, and now the visit itself becomes painful because they associate that with the loss of money. We wanna make sure that we can keep that focus on getting better, and not on the money that they were so willing to part with at the beginning when they were in such pain. So, we actually wanna put in all sorts of notifications that, when we check in a patient and they’re missing something, we can actually show you that.

So, I’m gonna no-show this patient. We’re going to check him in again. And we wanna say, “All right. This patient has a balance over $50.” In Chip’s example, he actually was talking about a patient who had a balance over $100, but we can automate this to run on a monthly basis, the third of every month for all your patients, or the third of the month for the patients that you want. You can set up those recurring payments to get triggered when there’s a certain balance. We wanna make sure that we set this up individually. But you might have some patients that you don’t want to run it automatically until you have a conversation with them, and we can notify you of that as well. So, this really allows you the freedom to put a policy and procedure in place for all of your patients, and then some of those patients that you know that that policy or procedure just isn’t gonna work for.

You know, we had somebody who was in a pretty big city, I’ll let the city remain nameless, where they were treating the mayor of a large metropolitan area. And they wanted to treat the mayor a little differently, so they wanted to put their own policy in place for just that one person. And so we help you do that. We help you take advantage of all of the robust features that a partner like ClearGage has to offer. So, when you put together that care plan and you know what the patient responsibility is going to be, we’re able to take those debits and those credits, and help you figure out how to apply them to the balances that have happened so far, so that you have a clear idea of what the patient owes, what’s been billed out so far and you don’t let a balance get so far out of whack that it’s uncomfortable to run a $400 payment without calling somebody. So, we wanna help you implement ClearGage, not the other way around. ClearGage doesn’t help you implement Genesis. We wanna help you implement a financial tool like ClearGage, and we have absolutely loved partnering with people just like Chip and his team because our integration isn’t the same as it was on day one. People have already made suggestions, and working with Chip’s team has been great because we’ve been able to even change some of the things that we’ve been doing together in a short period of time.

And the last thing I’ll mention is that patient financing that people are starting to take advantage of, we’ve got some pretty cool things to help implement that as well. Namely, when a payment is posted in a lump sum, we’ve actually put new reports in place for your escrow report to show you which payments have not been applied to charges. I know a lot of you out there listening are in states where you have to keep an escrow account available, so we’re gonna help you understand how much money needs to be in that escrow account for payments that have not been applied to charges, so that you can keep yourself as legal and as compliant as possible.
But I’m so grateful that we found people like ClearGage, so that we can put this type of solution together to make sure that your patients have a clear understanding of how their finances are gonna be handled when they’re in the care of your practice. Chip, anything else you wanted us to touch on today?

Chip: No. Thank you very much, Jason. We appreciate it. Chris, I know that we had some people typing in some questions. Were there any questions?

Christine: I believe that you and Jason have covered the material that’s the questions that were asked early on in the session, and you were able to get to them through your slides.

Chip: All right. Well then, we wanna thank everyone for their time. We wanna thank you for our friends at Genesis. And again, I think that the message is there clearly is solutions out there that you, as healthcare providers, need to embrace, and there’s processes out there that you need to embrace in your practice to make sure that you’re able to capture all of your revenue in a manner that’s patient-friendly and cost effective. And Jason, thank you very much for your time.

Jason: My pleasure, guys. It was great talking to you guys today. We love working with you. Looking forward to lots of years of this.

Chip: Bye. All right. Thank you, everyone.

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