We have much the same process. I found that there are a couple of critical puzzle pieces: (1) a good estimator tool; (2) staff training; (3) the ability to track results; (4) constant feedback; (5) alignment between management and line staff on objectives; and (6) recognition of excellent work.
We collect 90% of the approximate patient responsibility (co-pay and/or deductible). We don't try and be so exact that we get 100%. That results in a lot of patient refunds which can be a big hassle and lead to patient dissatisfaction.
I'm sure there different approaches and systems out there, but the 6 principles above apply regardless.
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