Methods That Pay Off Some Effective and Time-tested Efforts to Improve Collections

We are all aware that the recession has been slow to end and continues to impact the economics of medical practices. Your staffing levels have been reviewed, and expenses have been cut where possible. To make matters even more troublesome, insurance companies and Medicare continue to propose reimbursement cuts while pushing providers toward the implementation of expensive electronic systems.

With all of these pressures on your practice, it is essential that your collection efforts are as effective as possible. This article will help to identify those areas where the most impact may be seen in increasing your bottom line. The focus will be on your front-office staff, payment at time of visit, and billing after the visit.

Front-office Staff

With their welcoming smile and friendly greeting, your front-office staff are charged with setting the tone for the patient’s visit. While they are there to be helpful and show empathy toward the patient, they are also your first line of defense in ensuring that as much as possible is collected for each and every visit. It is critical that they obtain complete and accurate insurance information every time a patient is in for a visit.

To be most effective, it is essential that they receive proper training and support. This includes an understanding of what services co-pays can be collected for and how they can go about determining a patient’s co-pay if it is not readily available on the insurance card. They should also be trained in how to handle difficult patients. To be most successful, your staff should also be supported by technology wherever possible, such as debit and credit card machines and Internet search capabilities.

Your front-office staff should also understand the added costs of trying to collect a co-payment after the patient has left the office, and should be held accountable if they become lenient in this process. However, if they are successful in improving or maintaining a high collection rate at the time of the visit, consider rewarding them for their efforts. By collecting a $20 co-pay from five extra patients a day, you could potentially be increasing your cash flow by $20,000 per year.

Co-pays and Deductibles

Co-payments are the simplest of all payments to collect upfront, and one of the more difficult to collect after the visit. Also, the cost of processing, mailing, and following up on uncollected co-payments may actually cost more than the co-payment itself. As such, it is essential that as much is collected during the appointment as possible. A friendly reminder to all patients, such as a sign on the reception window stating that ‘co-pays and deductibles are due at the time of the visit,’ is generally helpful to your staff in confronting difficult or forgetful patients.

Deductibles and co-insurance can be a bit more difficult to collect upfront, but not always impossible if you take certain steps. First, consider obtaining insurance information in advance of the patient’s visit. This way, your staff can research the expected patient responsibility for the visit and can bill them accordingly, before they even step foot in the exam room. An alternative would be to create a back-office check-out area. With a completed chart and staff member proficient in coding, in some instances you may be able to determine the contractually allowed amount for the visit and request payment before the patient leaves.

In each of these cases, it is equally imperative to have a policy on patient refunds. That way, in those instances where the patient may have already met their deductible for the year, you will be able to return their money to them as timely as possible. Doing so on a consistent basis will make the patient more willing to pay up front, as opposed to waiting until they receive their explanation of benefits from their insurance carrier.

Billing after the Visit

Whether it is billing patients or insurance carriers, timely billing is your final line of defense in ensuring that your charges are collected. Insurance companies should be billed daily whenever possible. In the event that there is a charge dispute, or in those unfortunate cases where the wrong insurance company is billed, this ensures that the claim can be corrected or properly billed before the time to submit a claim expires. When a claim remains outstanding, consider following up with a phone call or e-mail. If a claim was not paid or even denied previously, resubmitting it tends to have little effect on the outcome.

With patient bills, it can be weeks to months before a request for payment can even be made while waiting to hear back from the insurance company. Sending invoices more regularly than monthly can often help to speed up the collection process. This can typically be expedited even further by reminding patients of an outstanding balance when they arrive for their next appointment.

Finally, be willing to work with patients on aged billings by setting up some form of payment plan with them. This will help show the patient that, while you are serious about collecting the money, you understand their financial concerns and are willing to work with them. A slow-paying patient is better than one who does not pay.

With the current economic pressures facing your medical practice, it is essential that you are as effective as possible in collecting as much as possible in a timely manner. By implementing a few key policies and procedures, you can help to ensure the financial well-being of your practice.

James T. Krupienski, CPA, MSA, is senior manager at Meyers Brothers Kalicka, P.C., Holyoke, MA Certified Public Accountants and Business Strategists; (413) 536-8510;www.mbkcpa.com