1. CINDY PEZZA, PMAC PINNACLE PRACTICE ACHIEVEMENT, LLC COMPASSIONATE COLLECTIONS

2. TIME TO TAKE OUT YOUR PENCILS

3. WHO DO YOU PAY FIRST? In today’s society nothing is free. Every household has bills and some are more important than others. Below is a list of commonly found household bills that need to be paid to survive. What payment do you make first? Please number 1-10, 1 being the most important and 10 being the least, for how you pay off your bills. Utilities Mortgage/Rent Groceries Car Loan Insurance (Auto or Home) Credit Cards Medical/Dental Bills Yourself/Savings Tuition Health Club ___

4. MAKE TWO COLUMNS What you know What patients know

5. 1. THEIR INSURANCE CARRIER (S) You know Most patients know

6. 2. WHICH CARRIER IS PRIMARY You find out and know Some know-very few seem to know the difference or understand the importance.

7. 3. COPAY/TIER AMOUNTS You know (or find out) Some know but few understand tiered copay systems

8. 4. THAT A DPM IS A SPECIALIST We hope you know! Few understand

9. 5. WHAT A DPM CAN DO Do you know about the schooling and experience involved in becoming a DPM? Where did your doctor go to school/perform their residency? Not many

10. 6. THEIR ANNUAL DEDUCTIBLE (INDIVIDUAL AND FAMILY) You have to find out, so YES! Some

11. 7. THEIR DME DEDUCTIBLE Again, you have to find out, so YES! Probably NOT, so FEW!

12. 8. WHAT DME IS? Durable medical equipment, OF COURSE! Durable medical WHAT... So, VERY FEW!

13. 9. VERIFICATION OF BENEFITS AND ELIGIBILITY Yes, you have to! That’s YOUR job, isn’t it???

14. 10. “APPROVAL IS NOT A GUARANTEE OF PAYMENT”... Of course you do! What, you mean insurance companies don’t always give the correct information about my coverage?

15. 11. DEDUCTIBLES AND COPAYS CAN AND WILL INCREASE Unfortunately, YES! Some realize, few want to admit.

16. 12. REFERRALS ARE TO BE IN PLACE AT THE TIME OF YOUR VISIT. Ah Ha! Oh, I thought you would get that for me.

17. 13. PATIENT RESPONSIBILITY REALLY MEANS... One would think! Are you sure, maybe we should try again!

18. 14. LOOK CAREFULLY WHEN ENROLLING Yes, the fine print says it all. Encourage patients to be careful when selecting a “better” plan. They may be surprised. “But I thought that it would be better because my copay went down.”

19. 15. COLLECTING COPAYS/BALANCES, ETC. AT TOS That’s what I have to do. It’s just the way it is. Of course! “But my other doctors just send me a bill.”

20. LET’S THINK ABOUT THIS..

21. WELL, IT’S TRUE!

22. 16. COVERAGE CHANGES Of course we know, Fee schedules change, covered services and acceptable procedure codes are modified, % of coverage changes. “What’s a fee schedule? EXACTLY MY POINT!

23. 17. THE RULES NEED TO BE FOLLOWED We are just doing our jobs and following with the guidelines of our contracted carriers. “But can’t you just write it off?”

24. SO THE QUESTION REMAINS... When did the Podiatry office become a financial planning institution?

25. NET 30 DAY BILLING CYCLE Archaic but most commonly used by businesses. Send out 1 st statement which gives the customer 30 days to pay off their balance, enclose a return envelope. Exactly 30 days later send out a 2 nd notice giving an additional 30 days for the customer to pay off their balance, enclose another return envelope. After the 2 nd notice expires send a “final demand” letter giving the customer another 30 days to pay off their balance, enclose your final return envelope. Once the final demand goes out start calling the customers about their balance. Why doesn’t this work?...

26. DON’T LET THIS HAPPEN TO YOU Letting a balance go unpaid gives more time for a customer to make up excuses of why they should not pay.

27. CHANGE IT UP Change the Invoices * Make each statement different by using different colored paper, stamps, handwritten notes, etc. Send out the 1 st statement after 15 days instead of 30 days. Make it easy for your customers to pay off their balance * Accepting all major credit cards and checks payments over the phone and by mail Show you care!

28. SAMPLE FINAL DEMAND LETTER Date: Re: Dear: We have given you every opportunity to satisfy your account balance of (amount due). If we do not receive a payment from you by (specific date), your account will be forwarded to our collection agency, First Financial Resources, Inc. Kind Regards, Ms. Jane Doe Financial Coordinator P.S. Sending your account to First Financial Resources, Inc. could impair your credit report.

29. CUSTOMER SERVICE Letters Do Not Collect Money! Call the Customers * Calls should be done within 30 days of the service being rendered * All calls should be professional and pleasant * Ask your customer how they are doing and wait for an answer * Mention their balance due Pros to Call the Customer First * Shows your customers you care about them * Shows you care about the quality of services they received The more calls you make the easier they become.

30. SAMPLE COLLECTION SCRIPT Good (morning, afternoon, or evening), may I speak with (customer/guarantor’s name) please? Hi, my name is (state your name) with (company’s name), how are you today? ***LISTEN*** I am calling today in regards to your past due balance in the amount of (amount due). ***LISTEN*** If they say they will pay: Ask if they can pay over the phone TODAY. If not, ask for the date they will be putting a payment in the mail. Make sure they have the correct amount and your address. Do not offer another statement if one is not truly needed. If they say they need more time: Find a Win-Win. Ask them when they will be able to make their first payment. If they can’t pay as a one-time payment, how long are they planning on taking to pay off the balance? If they refuse to commit to a payment: Confirm their address, social security #, and phone number. Then thank them for their time and move on to the next call. ***Don’t be afraid to ask WHY …Always try to finalize an account/get a balance paid in full TODAY !!!*** ***TODAY, TODAY, TODAY***

31. NEVER JUDGE A BOOK BY ITS COVER... People spend their money where they find value. They need their feet to be as pain free as possible. Even if they have to sacrifice...

32. “IF IT’S FREE, IT’S FOR ME!” Insurance coverage and selection of plans are not equivalent of a gold card for free care. “But I have insurance!” You have heard it all before.

33. THE BEARER OF BAD NEWS... Designate staff members to be responsible for having financial discussions with patients. Have your “financial educators” be empathetic but firm, state the facts clearly and in a way that allows patients to understand the situation and make an educated decision.

34. THE DPM’S ROLE IN FINANCIALS Podiatrists are foot and ankle experts, not financial advisors. They have years of education and training and are capable of diagnosing and treating patients presenting with a multitude of conditions. They should NOT be involved in the financial details of patients and their insurance plans. They should understand their role and know what to say in these delicate situations.

35. THE DREADED QUESTION Patient – “Will this be covered by my insurance?” Doctor – “Insurance carriers and plans vary in their coverage. Why don’t I have ( insert your name here) come in and discuss the details of your plan. This is her area of expertise. I try and stick to mine and help my patients feel better. She will be right in.”

36. OUR FINANCIAL ROLES... To be sympathetic but firm when it comes to collecting copays, deductibles, balances and what is owed for cash products and services at the... TIME OF SERVICE

37. TO EDUCATE AND INFORM Many times patients do not read the fine print, are confused about the details of their plan or simply do not understand concepts such as “non-covered services” and “allowed amounts.” It is our job to educate and inform them in a way that they understand these concepts as well as their responsibility.

38. PREPARE, DON’T SURPRISE It is important to prepare your patients for possible financial responsibility. Most do not read the financial agreements they sign as part of their intake forms upon initial visits. It is better to let them know ahead of time that their insurance company covers ___% rather than surprise them with a bill. Put yourself in their shoes (no pun intended)

39. NOTHING IS FREE Have set explanations for common questions/comments... “I thought my shoes were free” “I wish I were diabetic so they would cover my visit” “But I have insurance” “I can’t believe how much you people charge” “My other doctor said it was covered”

40. LET THE DOCTOR BE THE DOCTOR As much as possible, allow doctors to stay OUT of patients’ financial matters.

41. THE TRUTH IS... A medical practice is a business. We are an integral part of running the business. There is a fine line between caring for patients and addressing difficult financial (and sometimes emotional matters).

42. IT’S UP TO YOU!