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Addressing Medical Office Collections from Front to Back Good collections starts before the patient is ever seen for treatment…

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Presentation on theme: "Addressing Medical Office Collections from Front to Back Good collections starts before the patient is ever seen for treatment…"— Presentation transcript:

1 Addressing Medical Office Collections from Front to Back Good collections starts before the patient is ever seen for treatment…

2 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.

3 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 co- insurance 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.

4 Sample New Patient Form Paul Best, D.O. New Patient Intake Form Date:__January 10, 2009___ Patient Name: ____Julia Smith_____________________ Daytime Phone: ___ __________________ 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: ___W A____________________ Group: ___IA875000________________________ Verification: __Staff persons name__Date:___________ Policy Effective Date: ___ __ 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%.___

5 Verify, verify, verify… Insurance information should be verified- With every policy change If performing any treatment considered not routine (many policies dont 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

6 Verification can be done easily- 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.

7 Make a reasonable attempt to collect at the visit 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.

8 Sample Insurance Allowable Amounts AetnaBlue Cross Cigna $47.85 $52.91 $

9 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.

10 Team Work- When 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 patients 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.

11 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.

12 Billing Office – Statement Procedures Best Practices- Have 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 patients chart to be collected in the future if possible.

13 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.

14 Collection Agency Placement- Most reputable collection agencies are listed with the American Collectors Association (www.acainternational.org)www.acainternational.org There is also a Texas Chapter (www.texascollectors.com)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 – DebtColl.htm

15 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 Dont let debt remain on your books Follow good collection habits so you can avoid the need for a collection agency


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