Addressing Medical Office Collections from Front to Back

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 ___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 persons 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.___

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

• Aetna Blue Cross Cigna
• 99202 47.85 52.91 48.02
• 99203
• 99204
• 99205
• 99212
• 99213
• 99214
• 99215

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)
• 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/educati
  on/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