Transcript The Art of Collections - Migrant Clinicians Network

The Art of Collections
By Mary Ann Martinez-Gofigan
Director of Client Services
Pamela Zapien
Salud Family Health Centers, Inc.
Fort Lupton, CO
Adapted by Migrant Clinicians Network
Training Objectives
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Becoming familiar with the different programs
offered at The Health Center.
Communication with patients
Cashier duties
Collecting from patients
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Date of Service
Past Due Accounts
Safe usage
Health Center Programs
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Child Health Program
State Indigent Care Program
Women’s Cancer Control
Initiative
Federal Clinic Rate
Prenatal Program
Migrant Program
Family Planning Program
Others
Health Center Programs
For staff training, provide information regarding:
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source of revenue
qualifying services
patients eligible
Communication with Patients
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Patient Rights & Responsibilities: Payment is expected on date of
service.
Patients must sign Financial Policy form.
Full pay services vs. discounted services
Patients go through a financial screening process.
Patients are placed in appropriate program.
All sites have a “Please pay at time of service, Thank you” sign.
Communicate – Communicate – Communicate when you:
– Schedule Appointments
– Registration
– Throughout the visit
– At the cashier desk
Communication
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Be clear that payment is expected at the time of
service:
– In full
– Co-pay
– Old Balance
Communication
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Remember – Patients generally don’t get
upset about paying at the time of visit.
They get upset if there are “surprises”
regarding how payment is to be made or how
much, or if it is not anticipated.
Use your patient contact time during
appointment scheduling to clarify the
financial policy of The Health Center.
Let’s Get Started
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Have your cashier area organized and accessible
Expect patient to pay fair share
Collection more effective if done prior to visit
Collect current patient demographics (ask if they are
planning to move anytime soon)
Obtain insurance information
Verify Insurance information
Explain payment policy
Remind patient to bring insurance card
Make copies of insurance, Medicaid, Medicare cards
When patient calls for an appointment- Inform patient
about financial policy and if needing financial update
what documentation to bring
Collection Process
Total charges on encounter (Super bill)
 Apply discount if applicable
 Let the patient know what the total charges were
what the discount is and what their portion is….
“The charges for today’s visit is $120 after I apply
your discount of $80 your co-pay is $40 would you like
to pay with cash, write a check or credit card.”
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WAIT – WAIT – WAIT
Collection Tips
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Determine the sliding scale fee
Always, always start off by saying “The total charge is
$___ but after I apply your discount of $___your portion
is $____.
Sell the patient on the importance of paying today. It is
the best collection chance you have
Don’t ask if they want to pay today
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Expect them to pay….
Don’t ask how much they want to pay
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Expect that they will pay the full amount
Collection Tips
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If after your efforts the patient still cannot pay
today, obtain date they will return to pay for
today’s visit in full. (Do not go beyond 25
days)
Develop urgency. Explain that the health
center needs to be paid so it can continue to
provide care.
Persuade patients to pay their past due
balances with a credit card when
appropriate.
How to Ask!
State the total charge for services and depending
upon the discount policy how much they owe
“Today’s visit is $75 with your discount of $50 your
portion is $25 plus your outstanding balance of $25
your total amount is $50.
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WAIT WAIT WAIT WAIT WAIT WAIT
Don’t say anything but keep eye contact with the
patient.
How to ask!
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Be courteous – but remember:
“The first person to speak ,
loses.”
Improve Patient Relationships
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Get accurate registration information
including contact information (someone who
will always know where the patient is)
Verify insurance information
Inform patient of financial policy when
scheduling an appointment
Let the patient know what to expect
Payment is expected at time of Service
Expect that The Health Center will be paid at
What if the patient say’s NO!
How to handle a patient’s objection to pay
Patient: “I’ve never had to pay at the time of
service before. What do you mean I have to pay today?”
Response
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Many patients like taking care of their balances up front so
they don’t have to worry about it later. That’s why we’re
giving you the opportunity to pay now. Would you like to pay
by cash, check or credit card?’
Paying now helps The Health Center to avoid further billing
cost. We’re trying to do all we can do to control health care
costs for our patients, and to make sure The Health Center is
here if you need further care. Now, how would you like to
take care of your balance today?
What if the patient say’s NO!
Patient says: “I didn’t bring my checkbook.”
Response:
1. We accept cash or credit cards.
2. Would you like to call home to get your
credit card number, if you didn’t bring it?
3. Write in your own response.
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What if the patient say’s NO!
Patient says: “My ex pays for all medical
bills”
Response:
1. “No problem, I’ll give you a receipt showing
you’ve paid and you can send it to your ex
so he can repay you.”
2. “If you put this on your credit card today,
you can send the credit card bill to your ex
to pay.”
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What if the patient say’s NO!
Patient says: “I can’t pay in full.” or “I don’t have
the money.”
Response:
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You know we applied the discount to your charges
and payment is expected at time of service.
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We do take credit cards.
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You can pay with a post-dated check.
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You can pay half today, and then come in and pay
the remainder before statements go out.
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When the patient “Forgets” their co-pay?
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Ask the provider if the patient can be rescheduled
or if they should be seen.
If the patient has an “urgent” condition, make sure
the patient is seen.
Be sure to check the contract to see if there is a
past due payment. History being repeated….
Write down on the encounter in red when the
patient expects to return to pay.
– Ask patient to sign encounter…
Cashier Duties
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Taking Payment from Client
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Equipment Usage
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Customer Service
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Encounters
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Daily Deposit
Taking payment from Clients
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Day of Service Payments
Paid on Account Payments
Taking Prescription Payments
Past Due Payments (Contract)
Deposit Payments (Dental)
Equipment
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Cash Register
Credit Card Machine
Adding Machine
Computer PCN/Scinet
Web-sites
Safe
Customer Service
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Answer questions about client account
If unable to answer questions give them the phone
number to billing and the contact name
Collect Past Due Accounts
Write up contract with client to pay large past due
amounts
Give clients receipts for any payment
Remind client of The Health Center’s financial policy
Encounters
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Cashier is the last staff person to see encounter-verify insurance with patient
Make certain you have copies of insurance,
Medicaid, Medicare attached to encounter
List all charges on encounter while patient there
Place encounters with batch in order
Ensure all encounters are accounted for by end of
day
Key in encounters
If you fall behind 3 days with keying encounters
inform Client Services Director
Daily Deposits
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Must be done at end of each day
Count all monies
Subtract your starting bank
Count Credit Card amounts (Attach copies)
Count checks
Add all collections
Compare Cash to Collection on encounters
Should always come out correct
Place in bank bags and either deposit in bank or
send in to accounting. Daily…..
Safe Usage
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Only two people within the site will know safe combination
Do not keep the combination in your rolodex file or any location accessible
to staff
Safes must be kept locked at all times
At the end of each day, the deposit will be completed
Money will be counted, credit card slips, POS’s and Pharmacy receipts will
be attached.
Money will be placed in safe through the slot.
Start cash will also be placed in the safe, daily.
Deposit will be removed from safe and given to the internal courier in a
locked bank bag. To be sent in daily.
Bank deposit must be done on a daily basis.
A copy of the deposit slip and bank receipt must be faxed to accounting.
If safe combination changed, a call must be made to accounting with the
new combination.
The Health Center Financial Policy
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Has been approved by the Board of Directors.
Providers are in support of collections
Teamwork and communication with staff and the
patient is the best way to collect what is due to the
Health Center.
Collections allow for
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Continued service
Pay raises
Better working environment
Patient knows the value of the service
Resources
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Refer to the Client Services Training Manual at your site
Contact the Client Services Director if you have further
questions.
Contact Client Services Trainer for additional training or
questions.
Contact Data Entry for assistance
with encounters.
Others