An unpaid medical bill is typically the result of an eventful story involving surprise and tough decisions. This nature of medical debt can leave consumers feeling particularly vulnerable meaning a collection professional must handle accounts with thoughtful precision to protect the clients, patients and bottom line. Fostering an atmosphere of family in a collection office would not only protect client relations but exude a feeling of empathy that can be helpful on a delicate collection call. Calder Willingham, president of Creditors Bureau Associates, describes his family-owned collection agency and how an era of hefty regulation is greatly improved with a familiar sort of trust.
Tell us how Creditors Bureau Associates came to be and how you became involved in collections?
My father, Jay Willingham, opened Creditors Bureau Associates (CBA) in 1990 with one client. We now service over 200 hundred active clients. CBA’s focus is on medical bad debt collections for hospitals, physicians, EMS services. Our company has been truly blessed by my father’s leadership the past 25 years.
I graduated from University of Georgia’s Terry School of Business in 2006. Before I graduated I drove back and forth from Athens to start my sales role for CBA. CBA had seven employees when I started in 2006. We’ve seen a significant amount of growth in the past 10 years.
What do you do to optimize upper management’s performance?
With upper management we believe in incentivizing performance just like with our collector position. The more compliant and efficient the office runs, the more money we pay to upper management. A few metrics we use are call recording audits, queue integrity audits, and total fees collected.
What do you do to keep your collectors motivated and happy?
They represent our brand in the communities our clients serve. It’s crucial they feel motivated to provide great service in a way that is compliant and ethical. Our collector compensation model is based on hourly wage plus commission. In the process of hiring collectors over the past 10 years, researching pay for the position at the local and state levels, and then talking to other agency owners, we know CBA pays a higher than average commission by a large margin.
We are a small family owned business and our environment feels that way. We will meet and fellowship outside work several times a year. In June we had our annual lake party at Lake Sinclair in Eatonton, GA. We cooked out, swam, rode the inner tube and had a great time together. We all look forward to this event every year.
What was a particular challenge you met in medical collections and how did you overcome it?
In healthcare collections you must maintain close relationships with your clients. You need these great relationships to navigate the ever-changing laws regulating both healthcare and healthcare collections. You need great communication when working together on the client’s revenue cycle. If you do this well, then, they will allow you to be involved in their revenue cycle from beginning to end.
What has the CFPB done that affects medical collections the most and what do you think agencies must do to adapt?
Because of CBA’s small size and the fact we really push compliance all throughout our collection process we’ve not had many dealings with the CFPB. We rarely have consumers asking the CFPB to intervene on their behalf and communicate with CBA.
Of course we have had to make several changes to processes from CFPB rulings. The ruling that we worked the hardest to make sure we comply with is disputes to consumers credit reporting information reported by CBA. I believe creating a systematic process to deal with consumer disputes will actually help increase efficiencies. You should systematically identify consumers who do not believe they owe a debt (no matter if they truly do or do not) and notate that in your system and with the credit bureaus. You can stop wasting time and money on those accounts, and focus your energy on consumers who acknowledge and pay their deb.
What are some key implications of the FDCPA, HIPAA and TCPA in a medical collection agency?
Of course we make sure our staff communicates with consumers in a way that treats them with respect and dignity. With healthcare collections a lot of consumers we speak to did not plan to have the debt we’re collecting on. A lot of the debt comes from an unforeseen medical event that happened in their life, or their family’s life. We are sensitive to that. Also, with healthcare collections we put a big emphasis on creating processes that allow us to clearly identify who we are speaking to over the phone. We work really hard to never have third party disclosures.
The TCPA was pretty messy in regard to the use of automated dialers. Having to express consent before dialing a consumer’s cell phone created a lot of pain for a large number of agencies. Dealing with issues like this is another reason to have a strong relationship with your client. It makes overcoming them easier.
What is the key to establishing and maintaining good relationships with clients?
Number one is you have to present yourself and your company in a way that is trustworthy. It would be rare for a client, right off the bat, to trust you enough for them to invite you into a decision-making capacity in their revenue cycle. After having ongoing conversations with them you show them that what you are doing is working. You then earn their trust. While that may take a while eventually you will get to the point that you can work hand-in-hand with them to develop some strategies in the revenue cycle that could really benefit them.
What is a development you would like to see in medical collection technology?
What I want to see is actually something that needs to be addressed within the collection industry as a whole. I believe new laws regarding communicating with consumers with the technology we have available in the 21st century needs to be addressed by the CFPB. There are a lot processes that could be made more efficient on both the consumer and collection agency side if these concerns were addressed in an equitable way.
What processes could be made more efficient?
The main one that is the biggest pain is the lack of ability to communicate with consumers via cell phone with an auto-dialer. They’ve made rules against contacting them on cell phones unless they have given expressed consent to do so. There are more and more people who do not have landlines and the main way to contact these people is on their cell phone.
The other big one is there is a lot of inconsistency in law making for leaving messages for consumers. Collection agencies have been getting sued for leaving a message and not leaving a message. A suggested message was given to us by ACA International but people are getting sued even when leaving that message. It’s something for which the governing body needs to step in and give some clarification and set some solid common sense, 21st century rules making everything clear for everyone. That’s something that should have been fixed years ago.
What is a piece of advice you would offer an agency considering medical collections?
If the agency does not have the technology and processes in place to monitor their healthcare collector’s calls/compliance, that needs to be their first investment. You don’t have the leverage in healthcare collections that you might have collecting commercial debt. You must be sure to be patient-focused in collecting for your providers.
How is Creditors Bureau Associates involved in the community?
Creditors Bureau Associates is constantly looking for different opportunities to give back to our community. We enjoy giving to different entities in the Middle Georgia area and seeing the results of that giving through attending events that showcase how that giving is being used to affect the lives of people in the community. As CBA continues to grow we are looking at hosting our own community events that could train and educate the public about how to read their medical bills, credit reports, and how to create and maintain a budget for your family that’s debt free.