By Elizabeth W. Woodcock
MBA, FACMPE, CPC
Collecting patient due balances (including self-pay, high deductibles and health savings accounts) is in the current top 10 list of priorities for practice administrators, according to the Medical Group Management Association*. Assigning that level of priority to just one of the many issues that you, as an administrator, must manage may seem out of the ballpark, but your practice’s bottom line is dependent upon it.
Insurance products in the commercial and government sectors are being sold with high deductibles, often exceeding $5,000, which was unheard of just a few short years ago. Business rating firm Moody’s states, "Today's high deductibles are tomorrow's bad debt." *
As a practice management consultant for more than 20 years, I couldn’t agree more. Improving collections performance without adding unnecessary practice expense is a question I hear frequently from the physicians, managers and administrators. The market has changed, and it’s time to reengineer our internal processes to align with today’s reimbursement landscape.
Just hiring more staff in the business office is not sufficient; it’s time to take action that improves your practice’s collection function from top to bottom.
Asking your patients to pay is a true art form. When asking patients for payment, be pleasant but steady in your approach. Never laugh, but offering a warm smile is appropriate. Always look the patient in the eye and maintain eye contact throughout the payment interaction.
While some patients will never want to pay, others are prepared to tender payment at the time of service. Front office staff, often as instructed by management, have a tendency to brush off patients because of the complexity of the transaction. Our payment system is indeed complex, but it’s time to stop making that an excuse. The bottom line: if you don’t ask, you won’t get paid.
Replace old credit card terminals tethered to the wall with streamlined devices that are easily accessible at each workstation. Consider offering flexible payment applications like payment plans, card on file and online payments, deployed with an automated receipting process. To further streamline the process for your staff, integrate the new payment tools into the daily reconciliation process.
Results are limited, with patients largely ignoring the paper notices that show up in their mailbox. With snail mail on the decline in the U.S., many patients don’t even check their mail on a daily basis. A more effective strategy is to transmit statements electronically, linking an online payment system with an automated receipting process. Your time-of-service solution may include an e-statement option, or you may integrate the e-statements in your patient portal. Regardless, tie payments into your practice management system to electronically remit and to simplify the end-of-day batch-out process.
Another huge benefit? E-statements are free—a huge cost savings over paper statements that are transmitted through the postal system; with postage, printing and supplies, it typically costs $.75 to send each paper statement!
Furthermore, patient balances carry over from month to month, without increasing or incurring any penalties. With no sense of urgency, the patient has little incentive to pay. Include a specific due date on the statement, and don’t make it obvious that the payment doesn’t increase with each 30-day “box” that commonly appears on statements. Unfortunately, those boxes just highlight the fact that the patient can wait a few more months before paying.