Medical bills find a remedy

Robin Workman has made a career out of talking about something most people would rather avoid: unpaid medical bills.

Workman discovered she has a knack for finding out why patients and insurance companies haven't paid bills for health care services that are at least 90 days overdue - and persuading them to do so.

After working for 20-plus years for other companies as a bill collector, she, in 2005, formed a limited liability corporation, Medical Receivables Management of Colorado, and opened a home office in Woodland Park.

Business "exploded," Workman said, enough for her husband, Rex, to quit his 22-year job as a UPS manager and come on board as chief operations officer.

In just a few years, Workman said her company, which now has seven employees, has recovered more than $7 million for clients in five states, including Colorado.

That work netted the company more than $1.3 million, she said.

And now, the Workmans are ready to expand and plan to add more accounts to sustain a second office in Colorado Springs.

Clients have ranged from hospitals to outpatient surgery centers to private doctors' practices.

They need help with accounts receivable, Workman said, because in-house collection teams are often understaffed with employees who are underpaid and unmotivated - and it doesn't take long for overdue files to stack up.

After three months of trying to collect the money they're owed, many medical providers write off overdue accounts, Workman said.

That's become common in the health care industry.

"I find it totally unacceptable to write off big batches of money because Robin's showed me it doesn't have to be that way," Rex Workman said.

Robin Workman is quick to point out her company is a recovery, not a collection, agency, a step between the medical provider and a collection agency.

What's the difference?

Workman said her company acts as an advocate for the client and roots out what caused the situation.

Often, that's enough to get an unpaid bill paid.

"We explain how the balance got there and the claims process that includes deductibles and co-pays," she said. "Collection agencies don't answer questions; we do."

Workman's company also obtains access to medical information, and employees with a medical background can analyze payments in relationship to treatment.

Sometimes, she said, it's a simple mistake, such as insurance payers like Medicare and Tricare refusing payment because the claim was miscoded.

"With government payers, if you provide them the right information in the right format, they'll pay," Rex Workman said. "We understand how the system works and review contracts. We identify the issue, negotiate and ask them to reconsider."

Sometimes patients don't receive bills or don't understand what they're being charged for, so they don't pay.

Workman uses a soft-sell approach that doesn't include bullying or strongarm tactics that are characteristic of collection agencies.

She's willing to negotiate and set up a payment plan, for example.

Workman is so sure of her abilities that she doesn't charge upfront fees but gets paid a percentage of the money her company recovers for clients.

Her employees also get paid based on what they recover, which Workman said is an incentive to produce results.

"The money we recover is paid directly to the client, and we don't bill until the money is in the client's bank," she said, "But we're so successful that it works."

How successful?

Workman said she's able to recover about 50 percent of individual patient balances, when the industry norm is 19 percent.

Medical Receivables Management of Colorado has recovered about 85 percent of overdue accounts for Colorado Orthopaedic & Surgical Hospital in Denver, said Deb Dyas, chief financial officer.

"They take over accounts we were finding difficult to collect on, act quickly and many times are successful right then in getting a credit card payment," she said. "They have a magic touch and know state regulations and policies and how to get above the customer service level to someone who has more clout. They always go the extra mile."

In one project alone, the company recouped more than $100,000 for her hospital, Dyas said.

"That would have been lost reimbursements we wouldn't have otherwise gotten," she said.

Dyas said she also likes Workman's creative tactics: "Last month, they sent out a letter with a Christmas in July special, saying you got a discount if you paid the account full in 30 days."

Workman said her company's services aren't meant to be a permanent solution but an alternative way to address problem accounts.

She also evaluates medical providers' collection methods and offers training to improve their systems.

"A lot of providers are seeing a decrease in reimbursements from payers, and it's only going to get worse. You have to fight for every single penny," Workman said.