COMPLIANCE AND MAXIMIZING YOUR RETURNS

Transcription

1 COMPLIANCE AND MAXIMIZING YOUR RETURNS PRESENTED BY: JOHN KASZUBA & BRIAN BOYINGTON OF

2 LEGAL DISCLAIMER This information is provided for informational purposes only by Professional Finance Company, Inc (PFC). PFC does not warrant this information for any purpose. This presentation shall not constitute legal advice, nor does it create an attorney-client relationship. Any laws referenced in this presentation may have changed or could be affected by case law developments. Do not rely on this presentation or your interpretation of same for any purpose. If you have a legal question you should consult with a properly licensed lawyer.

3 Presenters John Kaszuba Regional Vice President, Business Development PFC since 2017 Healthcare experience 20 yrs Client relations and healthcare consulting background Brian Boyington Regional Vice President, Business Development PFC since 2010 Healthcare experience 17 yrs Revenue cycle & A/R experience 17 yrs

4 ABOUT A/R Solutions Since 1904: Primary & secondary debt collection Early-out self pay services Insurance services and billing Distressed receivables purchasing Greeley, CO National service provider 38 states 180+ employees 120+ years experience: senior mgmt. team

5 ADAPTING TO INDUSTRY CHANGES Multitude of Health Care Abbreviations: HIPPA, EMTALLA, ICD-10, CICP, etc... New acronyms: UDAAP FCRA CFPB TCPA 5

6 THE REGULATORY ENVIRONMENT The Consumer Financial Protection Bureau (CFPB) Unfair, Deceptive and Abusive Acts Policy (UDAAP) The Telephone Consumer Protection Act (TCPA) The Fair Credit Reporting Act (FCRA) Training Sound registration/service activation practices Well-articulated financial policies 6

7 RISKS FOR MEDICAL PROVIDERS 7

8 HEALTHCARE LITIGATION EXAMPLES Kaiser Permanente Hit With TCPA Suit Over Unsolicited Calls (APR 2013) Plaintiff alleged that Kaiser sent an unsolicited automated message to his cellphone, three months after cancelling health insurance coverage with the Kaiser Foundation Health Plan Inc Hospital company sued after FCC tightens medical debt collection rules (JAN 2016) 8

9 MORE Man sues Central Florida Regional Hospital over harassing' phone calls (FEB 2017) Patient said he received more than 200 phone calls for a $150 debt that he doesn't believe he owes Patient walked out of Central Florida Regional Hospital after a six-hour stay with a $12,000 bill Even though the insurance company paid it, the hospital contacted Ivy and told him he still owes another $150 Turner couple suing Central Maine Medical Center, debt collector (JUN 2016) A married couple are suing Central Maine Medical Center and a Lewiston-based debt collection service for civil contempt, saying the defendants have continued to demand $2,700 for unpaid hospital bills that the couple no longer owe because of a bankruptcy court judgment in Class action lawsuit says debt collector attempted to collect debts that weren't in collections (SEP 2016) A woman says a Chicago-based debt collection firm improperly attempted to collect a medical debt she owed, under a payment plan she maintained she never agreed to, and even though she was never placed into collections The woman has now filed a potential class action suit 9

10 MORE Kolinek v. Walgreens Co. (N.D. Ill. 2015), involving automated prescription refill reminders to cell phones, which settled for $11 million Lees v. Anthem Insurance Cos., Inc. (E.D. Mo. 2015), involving autodialed calls to cell phones placed by a healthcare vendor, which settled for upwards of $6.25 million Ferencz v. International Clinic Consultants, LLC (Wash. Sup. Ct. 2014), involving unsolicited text message advertisements that promoted services for a men s health clinic, which settled for $3.5 million 10

11 MEDICAL DEBTS VS. CONSUMER DEBTS Unpredictable Cost not always identified before purchase Can be very expensive Timing: Debt results from a time of weakness Payment may not be due proximate to time of purchase 11

12 CONSUMER CONFUSION Multiple payers (insurance) and who owes what Who owns the debt? Insurance complexities Multiple billers bill separately Physicians rarely collect their own overdue bills 12

13 CONSUMER FINANCIAL PROTECTION BUREAU (CFPB) STATISTICS 52% of all debt collection on credit reports = healthcare debt 19.5% of credit reports contain overdue healthcare debt (1/5) 43 million Americans have overdue medical debt on their credit reports 15 million consumers have only medical debt on their credit reports Smaller debt for health care: median = $207, average = $579 Larger for finance companies: median = $515, average = $1,785 Largest for auto: median = $3,995, average = $5,587 FICO Report: Any collection tradeline of >$100 on a credit report drops a score from 680 to 640, 780 to

14 THE TELEPHONE CONSUMER PROTECTION ACT (TCPA) Passed into law in FCC Declaratory Ruling Automated Telephone Dialing System (ATDS): Any capacity to dial random or sequential numbers Dialing from a list of numbers All modern dialing equipment Technically only a rotary phone is not an ATDS 14

15 IMPACT OF NEW TCPA RULING Need to obtain prior express consent to contact consumers Modern phone technology/efficiency nullified Consumers may not receive information they want or need TCPA litigation risk: $500 to $1,500 per call Damages legitimate businesses, bad actors continue abuse 15

16 PRIOR EXPRESS CONSENT Any call to cell phone without prior express consent violates TCPA 1 call allowed to wrong or reassigned number >1 call = Violations of TCPA begin regardless of wrong/reassigned number knowledge Ask patients to sign a form that says they can be called on the phone number(s) 16

17 LIMITED HEALTH CARE AND GOVERNMENTAL EXEMPTION Calls allowed without prior consent: Exigency (Safe Harbor) Health care treatment purpose Appointment and exam confirmations and reminders Wellness check-ups Hospital pre-registration instructions Pre-operative instructions Lab results Post-discharge follow-up Drug prescription notifications Home healthcare instructions Calls requiring prior express consent: Telemarketing Solicitation or Advertising Accounting Billing Debt collection Financial content/information Insurance 17

18 EXEMPT CALLS MUST SATISFY SEVEN CONDITIONS 1. The voice call or text message must be sent to the wireless phone number that the patient provides; with respect to text messages, the patient cannot be charged, nor can the text be counted against the limits of a wireless telephone plan 2. The name and contact information of the healthcare provider or organization must be stated at the outset of a voice call or prominently noted within a text message 3. The voice call or text message must comply with HIPAA privacy rules and cannot include telemarketing, solicitation, or advertising content, nor can it pertain to accounting, debt collection, or other financial information 4. The message must be concise: e.g., one minute or less for voice calls and 160 characters or less for text messages 5. Healthcare providers are limited to one voice call or text message a day, up to a maximum of three combined calls/ messages per week per provider 6. Recipients must be offered an easy opt-out option within each message: e.g., a press-activated mechanism or a toll-free number for voice calls, and replying STOP for text messages 7. All opt-out requests must be honored immediately 18

19 1. Get it in writing OBTAINING CONSENT 2. Separate form signed by patient at intake 3. Clear language that patient consents to be called at number provided by automatic dialing system and prerecorded voices 4. Have form state that consent flows to assignees 5. Get alternative numbers, , etc. 6. Keep information updated 19

20 REGISTRATION AND THE MOUNTING PRESSURE Quasi-Credit granting environment Registration is focused on obtaining proper insurance billing information Service Providers who rely on phone activation require proper billing information Additional Registration focus: Providing necessary disclosures (HIPAA, TCPA, etc.) Disclosure of payment expectations/non-payment consequences Balance the right of patient privacy with the right of the healthcare provider to collect amounts owed Regular updates of demographics 20

21 INFORMATION IS KEY Healthcare Registration & Customer Service Personnel are the Gate Keepers - Must be trained on gathering new information Difficult transition for tenured staff Emphasis on Fair Exchange : Quality service for adequate information Passive (forms) and Pro-Active (verifying) methods for information gathering 21

22 WHAT INFORMATION? Full Name: Middle and suffixes Current Address: Obtain street address if PO box Marital Status: Spouse s full name Telephone Number: Ask for all numbers, including spouse s Employer Information: Employer name, occupation, spouse employer information SSN: Full or last 4 DOB Address Signatures Copies of Photo ID Call Recordings: Service activation recordings 22

23 WHY IS INFORMATION COLLECTION SO IMPORTANT? TransUnion, Equifax, and Experian overhauling credit reporting practices: In effect January 1, Information Requirements: Full Name (first, middle, last, generation code/suffix) Address Full SSN DOB (mm/dd/yyyy) 2. No reporting on debt that did not arise from a contract or agreement to pay 3. No reporting before 6 months for medical debts Credit reporting agencies currently deleting accounts upon receipt of disputes from consumers without investigation 23

24 WHY BOTHER CREDIT REPORTING AT ALL? Integral, passive method of collection process Directly affects collection liquidation Case Study: Consider a recent, actual case study of a large PFC client who made an executive decision to abandon credit reporting in October Compounded by the limitation to telephone collection efforts imposed by both the FDCPA (frequency) and TCPA (dialer) - Liquidation for this client went from 20.82% in September 2015 to 7.67% in April 2016! Credit reporting remains in play longer than a State s statute of limitations. Consumers are responsible to pay their debts to obtain credit. 24

25 QUESTIONS & ANSWERS Thank you for the opportunity to share the importance of compliance for communications and collections with you! Resources: PFC: Consumer Financial Protection Bureau: CFPB White Paper: Federal Communications Commission: Association of Credit and Collection Professionals: 25