Phase 1: Account Ingestion & Validation
Receivables are securely imported from your EHR or billing system (Epic, Cerner, Meditech or equivalent).
Accounts undergo full audit for payer denials, duplicate charges, coding or billing errors, charity-care or financial-assistance eligibility, and statute-of-limitations review.
Invalid or non-collectible accounts (bankruptcy, deceased, time-barred, insurance-approved but unpaid) are filtered out before collection efforts begin.
Validation notices are generated where legally required.
Phase 2: Patient Outreach & Communication
Initial notices are sent within 24 hours, providing a clear summary of balances, financial-assistance rights, and payment or settlement options.
Multi-channel outreach includes phone, secure patient portals, SMS, email, and postal mail, with contact attempts limited to legally allowed hours (e.g., 8:00 a.m.–9:00 p.m.).
Empathy-based, compliant scripting ensures respectful, patient-centered communication aligned with consumer-protection and debt-collection laws.
Phase 3: Resolution & Payment Processing
Flexible repayment options include zero-interest plans, lump-sum settlements, ACH, credit/debit cards, digital wallets, and HSA/HRA payments.
Secure, encrypted payment portals with PCI-compliant gateways sync all payments in real time with PMS/EHR for accurate posting.
Receipts with full disclosures document payment terms, settlements, and remaining balances to maintain transparency and audit readiness.
Phase 4: Compliance, Security & Auditable Workflow
PHI is stored and processed securely using encrypted, role-based access with audit logs and breach-notification protocols following HIPAA or applicable law.
Staff receive ongoing compliance training covering federal and local debt-collection, billing, privacy, licensing, and bonding requirements.
All interactions and transactions are documented, ensuring a complete audit trail for internal oversight or regulatory review.
Phase 5: Patient-First Ethical Collections & Assistance
Patient dignity and transparency guide all communications, with clear billing explanations and financial-assistance opportunities.
Self-service tools allow patients to review balances, request payment plans, access charity-care information, or submit disputes securely.
Resolution is prioritized over pressure, treating collections as part of patient financial care while safeguarding provider relationships.
