It is critical that a doctor’s office receive payment in full for the services they provide as quickly as possible, but patient participation in the payment for healthcare services has made the whole process far more complex. The collection process is extremely complex in healthcare, with payments often coming from multiple sources.
With rising patient responsibility, this situation creates a complex set of trends that translates into increased financial risk for medical practices with poor financial controls. For most medical practices, passive approaches to collecting patient balances should no longer be acceptable.
But how can providers best utilize their existing resources in the payment collection process? There are certain technological solutions that can be easily implemented and used to improve revenue cycle management and provide for a positive patient experience when patients are called upon to pay for their portion of healthcare services.
Insurance companies and employers purchasing health insurance both accept the premise that higher deductibles and co-pays will lead patients to be more responsible for their health and their healthcare decisions. This change in direction, however, puts more pressure on medical practices to collect patient payments in a timely manner, as these payments represent an ever-increasing part of your overall revenue. Only a diligent effort on the front end will ensure our collection percentages remain strong.
Assess Current Processes
Healthcare in 2018 has brought higher patient co-pays and deductibles. Patient responsibility for payment continues to grow, becoming a larger percentage of your practice’s total monthly revenues. Effective patient collections are more critical to the financial health of your practice with every passing day.
Begin by meeting with your staff to discuss the importance of …
- Instilling a culture of responsibility amongst all employees;
- Improving patient engagement and satisfaction through a better understanding of your practice’s financial policies; and supporting your practice’s financial viability through collaborative efforts to collect patient co-pays and past-due balances; and
- Encourage input and discussion amongst staff responsible for patient registration, appointment scheduling, insurance verification, and pre-certs. Your staff should provide valuable insights into their processes and serve as champions for implementing improved financial controls.
The goal of staff discussions is to develop and implement protocols that …
- Foster patient compliance by improving the patient experience. Ensure that all patients receive clear, consistent, and timely communication that would enable them to make fully informed decisions about their financial obligations to the practice;
- Deliver financial assistance to proactively and consistently offer payment plans to those who cannot pay their balance in full. Do not wait to have these discussions until their statements are 90 – 120 days past-due;
- Achieve financial stability. Establish appropriate patient payment processes to achieve stability in financial risk.
Areas of Increased Attention…
- Co-pay Collections
- Your goal should be to collect 100 percent of co-pays and past-due patient balances every day. Measure your staff effectiveness by daily tracking scheduled collections vs. actual collections. Ask each staffer who collects copays/deductibles to complete an “If Not, Why Not?” report each day for the monies they do not collect.
- Communicate with your patients– via your website, EMR patient portal, appointment reminder calls, etc., the Patient Responsibility for promptly paying co-pays and past due balances before additional services are rendered.
- Improve the “Ask.” You will find that some employees are instinctively better at collecting patient payments. Have other employees observe their techniques. If you have a small staff, consider having your front-office personnel take a field trip to another office to learn.
2. Identify Patient Responsibility Prior To Their Visit
- Check insurance eligibility on every patient prior to every visit to identify what co-pay and/or deductible is due; and ensure the patient’s insurance is active.
- Let your patients know what payment you will expect at the time of their visit. Eliminate potential patient excuses, such as, “I didn’t know the cost of today’s appointment would apply to my deductible.”
- Numerous online insurance eligibility programs permit you to do real-time eligibility / benefit status verification at the time of service.
- Payment Options.
- Patients are creatures of their own habits. Make sure you have payment options that make it easy for them to pay you.
- Accept cash, checks, debit cards, and credit cards. More payment options mean more time-of-service collections.
- Accept check and credit card payments through your website.
- Payment plans
- Set up payment plans for those patients who don’t have the money and indicate that they are willing to pay their bill in installments.
- A payment plan should be documented in writing and signed by the patient. The payment plan should spell out what will happen if the patient misses a payment.
- Payment plans should not extend beyond six months, with tiered thresholds based on the amount due.
- Explore a “credit card on file” (CCOF) program. Once an insurance claim is processed and contractual adjustments are made, the patient receives a statement. If the statement is not paid within (30) days, the remaining balance due from the patient is charged to the credit card and the patient is sent a final statement summarizing the transaction. This process keeps your accounts receivable due from patients to a low, manageable level.
The concept of CCOF is similar to that of a hotel’s payment policy. The medical practice is protected from non-paying patients.
Benchmark your patient collection strategies to see if you’re set up to increase profits or increase patient receivables in 2018-2019.
Below are a few questions related to your revenue cycle processes to guide your discussion with staff.
- Have your patient receivables grown in the past 12 months?
- Do patient receivables make up more than 20% of total revenue?
- Are patient receivables more than 60 days past due?
- On average, do you send more than 1 statement per patient?
- Do you make collection calls to more than 5% of your patients?
- Are less than 50% of patients paying their bills online?
- Does it take more resources (time and collection cost) to collect from patients who have not met their deductible?
If you answered mostly “yes” to the above questions, it may be time to consider a change in how you communicate your practice’s financial policy and collect from patients.
- Do you have conversations with patients about their financial responsibilities BEFORE their visit?
- Do you use online patient eligibility verification tools?
10. Do you set up patient payment plans secured with credit cards and/or checking account debits?
If you answered mostly “no” to the above questions, there are simple fixes available to increase your cashflow.