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The Field Guide to Physician Coding 2nd Edition


General

Are You Collecting All You Can From Your Patients?
Author: Donna Weinstock


How many of you are having trouble increasing your revenue? How hard are you working to collect the money owed to you by patients? Whether you are owed copays, deductibles, coinsurance or even deposits, the easiest way to add to your revenue is to increase your patient collections. Make collection a team effort.

The best way to collect money from patients is when you are face to face in the office. By training your front staff to ask for money, you have an opportunity to get what is owed to you. In coaching your staff, they should use phrases such as, “You have a balance of….how would you like to pay for this, check or credit card?” By not offering the patient a choice of whether to pay,
your chances of collection increase.

Scripting will help your staff feel more comfortable. Have set responses based on what a patient replies. Role playing will also help your staff be more at ease asking for money.

It is important that the front desk staff know which patients owe money and the reason the money is owed. Is it:
  • Copay
  • Deductible
  • Balance due
When a patient states that he can’t afford to pay the full amount, offer the opportunity to make monthly payments. The larger the bill, the longer the payment plans can be, but work to have balances paid off as quickly as possible.

It is also important to check eligibility and benefits prior to a patient being seen in the office. Knowing if the patient has benefits in effect, whether he has met his deductible and what his coinsurance is allows the staff to collect those items at the time of the visit.

With high deductibles and HSAs, patients frequently have high balances. For those practices that perform surgery or procedures, it is helpful to know if the patient has a high deductible. Have the patient pay a deposit prior to the surgery. This reduces the amount the patient will owe after insurance processes the claim. Lower balances makes for easier collection.

Your practice should accept credit cards if you don’t already do so. This offers patients another opportunity and means to pay their bill. Let the credit card company carry the balance. In the same light, if you often have patients with high balances, perhaps you should consider offering financing through outside sources.

Having a written financial policy that states your practice’s expectations, allows patients to be aware of what the expectations are. How can a patient meet an expectation unless they know what it is? Your financial policy should be straightforward and easy to understand. Your patient should sign the policy and be given a copy for their records.

The financial policy should include (but not limited to):
  • What the patient should bring to his appointment
  • Whether your physician is contracted with the patient’s insurance
  • The policy for being out of network
  • The policy for uninsured patients
  • No show or cancellation in less than 24 hours
  • The guidelines for payment plans
Send regular, consistent statements on a monthly basis. Send the first statement as soon as the insurance responds. There is no reason to wait until the end of the month if you are paid by insurance at the beginning of the month. This speeds up the process of collection by patient.

There are times when it becomes impossible to collect patient balances. When this happens, it is realistic to consider a collection agency to aid in the process. Generally, the practice will pay two or three statements and perhaps make one or two collection telephone calls prior to sending the patient to collection. Collection agencies also have their own collection policies and letters.

A few other thoughts to increase patient collections:
  • Keep small dollars in petty cash to make change for patients who want to use cash to pay
  • their copays
  • Offer on-line payment of balances
  • Offer a quiet, private place to discuss money with your patients
  • Consider finance charges for past due accounts
  • Be conscious of state and federal laws when collecting money
As always, your focus is quality healthcare for your patients. That does not negate the need for running your practice as a business. Yes, your practice is a business. Patients should be expected to pay their portion of their bills on a timely basis.

Collecting money is everyone’s job. The billing and collection staff is not the only ones who should be collecting. Your front desk also needs to be involved. Encourage the team approach and reward your staff for doing a great job collecting.

American College of Surgeons
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