Transcript Addressing Medical Office Collections from Front to Back

Addressing Medical Office
Collections from Front to Back
Good collections starts before the
patient is ever seen for treatment…
Do all you can to avoid collections
Best medical office practices –
 If your office has no established
collections practices – start here
Consider what your expectations will be
of your patients and their payment
for services.
Best Practices
We suggest;
Educate patients on your payment policies while they are
making their appointments.
 Inform them of what they will need to be prepared to pay
for their services
Ms. Smith calls the office to make an appointment for a
respiratory infection.
A new patient information sheet is begun over the phone,
recording her phone number and any health insurance
information she may have.
If she has insurance, she is asked to please be sure to bring her
insurance card with her to her appointment and her coinsurance payment.
If she is not on health insurance, she is informed in advance of
the estimated charge of her appointment so she can come
prepared.
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Sample New Patient Form
Paul Best, D.O.
New Patient Intake Form
Date:__January 10, 2009___
Patient Name: ____Julia Smith_____________________
Daytime Phone: ___512-555-5855__________________
Patient Date of Birth ___01/09/1966_________________
Date of Appointment: __Thursday, January 15, 2009____
Nature of Appointment: ___productive cough, sore throat
Insurance: ___Aetna______
Policy ID: ___W5555555A____________________
Group: ___IA875000________________________
Verification: __Staff person’s name__Date:___________
Policy Effective Date: ___01-01-2009__
Benefits:___$20 per visit copay, all routine lab and xrays payable at 100% of allowable with use of
contracted facility, annual physical and well service examination once per calendar year
payable at 100%.___
Verify, verify, verify…
 Insurance information should be verified With every policy change
 If performing any treatment considered not routine
(many policies don’t cover immunizations after age 18,
most policies treat even minor surgery as well, a
surgery and deductibles usually apply, physical
therapy, not all in-office labs or x-rays are allowed)
 If it is the first of the year, first of September (first of
a fiscal year) or the patient has not been treated in
more than 3 m
Verification can be done easily
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There are a number of options to easily verify patient
insurance
On line
Swipe terminals that also handle credit/debit card payments
No one likes this job, so have an office routine that includes
pulling established patient charts the day before their
appointment to verify insurance.
Then verify new patient insurance policies from the sheets filled
out as the appointments were made.
Doing this will free up time for walk in or unexpected patients
during the day.
Make a reasonable attempt to
collect at the visit
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Collect copays in advance of the appointment whenever possible.
“Welcome to our office Ms. Smith, it looks as though you are still covered by
Aetna, may we please collect your $20 copay?”
When your office has an established routine that is consistent, patients and staff
know what to expect of each other.
If patients are expected to pay a percentage of the insurance allowable amount,
then collect that data from the person posting insurance payments – have
them put together a list of your most popular insurance allowables by
company for the different services you provide.
It is always easier to collect before patients are seen than once they leave the
office.
Billing for copays and deductibles costs the practice money and can alienate
patients.
Sample Insurance Allowable
Amounts
99202
99203
99204
99205
99212
99213
99214
99215
Aetna
$47.85
Blue Cross
$52.91
Cigna
$48.02
Collection Techniques
 Ask for the payment politely
 Drop your gaze
 Begin to write out the receipt
This makes it uncomfortable for patients to ask for a payment
deferment.
If the patient says they forgot their checkbook, kindly point them to
the nearest ATM and or offer to hold their appointment for them
for a reasonable time so they can run home and get their
checkbook.
You can swap their appointment time with the person behind them in
the schedule usually to allow for this.
This also sends a clear message to those in the waiting room that there
is a policy regarding payment at the time of service and it is
adhered to.
Team WorkWhen the front office personnel are careful to verify insurance before
the visit, get copies of cards, inform patients of collection
procedures ahead of time, collect payments at the time of service
consistently –
Then the billing personnel has a lighter job load and can focus in other
areas of billing and collections.
The billing person(s) should work with front office personnel to avoid
letting patient’s with past due balances avoid payment.
Put copies of statements inside charts, use your patient billing software
features to aid in keeping appointment schedulers and other key
staff aware.
Patients who owe a past due balance and call in for a prescription refill
may be due for a visit and can be informed to bring their payment
to the visit.
Cross Train Many times, offices are small and the receptionist
makes appointments, collects payments, answers the
phone and enters patient charges.
 Have other staff such as back office personnel and
billing staff trained to answer the phone if it rings a
third time.
 Have other staff trained to pull patient charts, verify
insurance and collect payments if necessary.
 Teach those doing data entry how to post payments
and meet regularly about services that can fall
through the payment cracks.
Many times, this extra training can keep staff from
burning out, keeps the office running smoothly and
more efficiently and ensures a health cash flow –
saving jobs and keeping stress to a manageable level.
Billing Office – Statement
Procedures
Best PracticesHave a routine for sending statements and use
it consistently. (try Bill Flash)
For larger practices divide statements into
groups and send weekly.
Have a limit on the number of statements you
will send – such as three.
At the fourth statement the balance either
goes to a collection agency or gets written
off with a copy of the write off filed in the
patient’s chart to be collected in the future
if possible.
Collection Agency Placement
In most cases, collection agencies rarely work for the overall
benefit of the practice.
Most practices report that it alienates their patients and they
loose them and any referrals they might have gotten.
It puts them in the role of creditor rather than caregiver.
Collections agencies typically charge a placement fee up front
and then a percentage of the payment(s) that are actually
made.
So again, it is best to collect payments at the time of service.
Collection Agency PlacementMost reputable collection agencies are listed with the
American Collectors Association
(www.acainternational.org)
There is also a Texas Chapter
(www.texascollectors.com)
There are rules for code of conduct etc. and collections
practices.
Be informed in advance of their fees and policies.
Office of Consumer Credit Commissioner – 800-538-1579
http://www.occc.state.tx.us/pages/consumer/education/
DebtColl.htm
In Summary
Have a policy for payments
Create a routine and follow it consistently
Always be polite and courteous
Inform patients of your policies and make it
easy for them to follow
 Cross Train your staff to reduce burden and
boost productivity, knowledge and skill sets
 Don’t let debt remain on your books
 Follow good collection habits so you can
avoid the need for a collection agency
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