Collecting from Patients in a Difficult Economy

Despite the fact that more Americans have health insurance, many still struggle to pay their medical bills due to the increasing number of high deductible health plans.  Collecting from self-pay patients can be also be costly for a medical practice since it typically takes more time and hassle. 
Not only do statistics show that 81% of self-pay net revenues go unrecovered but that self-payers default at a rate of 30% or more. Therefore it can cost twice as much to collect from a patient as it does from a payer. 

Collecting money from patients is one of the hardest things about managing a medical practice, but how your staff handles it can greatly affect patients' perception of your practice for good or ill. Here are some ideas for improving revenue collection and increasing self-pay patient payments.

1) Distribute a written policy to all patients.

Developing, writing, and distributing a financial policy for your practice is wise. This way, every new patient receives a copy of your policy, and you can even ask that they read and sign their consent to it.

Your financial policy spells out when co-pays are collected, what payment options are available, and whether resources are available for making alternate arrangements (like payment plans). Establishing your financial expectations at the outset helps patients understand their out-of-pocket expenses better and understand their payment options.

2) Hire knowledgeable front desk staff.

Skilled front desk staff can prevent financial misunderstandings and help with your patient payment strategy. Front desk staff will need to be trained on the art of collecting from patients and be able to handle common insurance questions.

For example, they can explain to patients what co-payments are, and how insurance doesn't cover the entire cost of care. They can also communicate what will happen if a patient asks for something above and beyond (like bringing a child's sibling to a well child check-up because he is sick - essentially trying to get two visits for one). When your intake personnel can explain scenarios clearly, the risk of billing misunderstandings drops.

3) Have a policy of collecting co-pays up front.

Collecting co-payments upon check-in is beneficial for many reasons. It lets patients who "left the checkbook in the car" retrieve it or reschedule the appointment, and it prevents people from seeing the physician without making a co-payment.

It also benefits the patient in that once the appointment is over and any follow-up is scheduled, he or she is free to leave without stopping by the billing desk to make a payment.

4) If you don't accept credit cards, reconsider.

Accepting credit cards means accepting the costs associated with processing them, but it can improve collections enough to be worthwhile. Most patients have credit cards, and they don't even have to be on the premises to use them.

If you use an EHR solution like eClinicalWorks, you have access to a patient portal that allows people to pay by credit card online. You can also accept credit card payments by phone if you follow the regulations for phone transactions required by your processing provider.

5) Create a credit card on file (CCOF) policy.

Some practices have implemented a "credit card on file" policy where the practice retains a credit card number, but bills as usual. A credit card on file policy  Only if the practice is unable to collect for services will it process the patient's credit card for that amount.

If you do this, you should document the process in language patients can understand, and have patients sign a form allowing their consent to this. Along with payment plans, online payments, and payment by cash and check, a credit card on file policy can help maximize collections.


6) If all else fails, dismiss the patient.

When all else fails, dismiss your patient. When patients chronically disregard policies and procedures, are rude to staff, or make unreasonable requests (like back-dated work excuse requests), you have the option to discharge them.

Nobody enjoys paying medical bills, but that doesn't give patients an excuse to disrupt your practice or abuse your staff. When you discharge an exceptionally difficult patient, put it in writing and send it by certified mail and regular mail. Your practice counsel can help you draft a letter regarding notifying patients you're ending your relationship with them.

Having a self pay patient payment strategy is the first step towards increasing your collections and decreasing high patient AR.  GroupOne Health Source specializes in medical billing services for EHR users that are looking to overcome patient pay challenges.

Schedule a revenue cycle management demo with us today to learn how GroupOne can help your practice get started with a patient payment strategy. Our online patient payment technology combined with a credit card on file program can take your practice to the next level of financial success.

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