If you have worked in a medical office for a long time, then you have probably seen a lot of change in the way providers are paid. In the past, doctors used to rely on a patient’s insurance to cover most of their health care costs. Now, more insurers are paying less of the cost share with in-network fee reductions and a shift to higher deductibles and co-pays. The services the physician provides may be the same, but the patient bears more responsibility for the costs of care...
This puts more pressure on provider offices to work smarter and faster to collect payments from patients, and this burden will grow as time goes on. The Centers for Medicare and Medicaid Services (CMS) reports medical spending represents 17 percent of the GDP. By 2025, that number will grow to about 20 percent. (1)
If your services to collections ratio is rising and your office has more money on the books than in the bank, you may already be facing an uphill battle. A slow or outdated collections process will almost guarantee that your revenue will end up at the bottom of your patients’ stack of medical bills.
Moving your collections in a positive direction is attainable, especially when you employ multiple lines of attack. I’m here to tell you that this is possible! Start now by taking a comprehensive look at your payment policies and collections efforts.
How to Improve Patient Collections
Here are some tips that will help move your patient collections in the right direction.
- Be proactive. I cannot emphasize this enough. Focus on complete and timely payment for services rendered. Explain all charges up front or as early in the process as possible so the patient understands the scope of their responsibility. Make sure they read, understand and sign your office payment policy. Collect co-pays at time of service.
- Be careful. It is customary to collect co-pays up front, but deductibles and coinsurance amounts may be prohibited from collections until the claim has been processed. Check each of your managed care agreements for the rules on collecting deductibles and coinsurance amounts up front.
- Work fast. Delayed billing will almost guarantee that your provider’s bill will end up on the bottom of the stack. Whenever possible, communicate estimated charges up front, before the patient receives the services. If you wait until after the procedure, you may have to get in line as the patient collects bills from the anesthesiologist, pathologist, facility, lab, medical devices, etc. They may be blindsided and unprepared when they realize that their single medical condition/procedure involves charges from multiple entities.
- Use technology. Auto-pay is a good, no-hassle option – a win-win proposition for you and patients. A PCI-compliant credit and debit card processing solution is a worthwhile investment: no paper, checks, envelopes, stamps. Statements can be delivered electronically.
- Show compassion. Your collections staff should have good communication skills and exhibit compassion when walking patients through their financial obligations. A little kindness can go a long way.
The average American has very little money set aside to cover medical expenses. High deductible plans are putting more of the financial burden on the patient. Provider offices must remain diligent in their collections efforts to keep the practice solvent!
More Help with Collections
Enroll in PMI's Certified Medical Office Manager to improve communication with providers, third-party payers, patients, and business associates. Learn guidelines and examples that will improve decision-making and tactical skills. Graduates of this program will be better prepared to manage risk, motivate employees and improve the financial outlook in a medical office.
Lisa Maciejewski-West, CMC, CMOM, CMIS, MCS-P, has been involved in the medical billing, management and consulting field since 1982. In 2006, she founded Gold Star Medical Business Services, an award winning company that provides remote billing services for physicians in small to medium sized individual and group practices. Prior to starting Gold Star Medical, she worked for one of the largest Practice Management consulting firms in the country.
Lisa has consulted with hundreds of doctors as a practice management coach, and has spoken at hundreds of seminars throughout the United States, both as a teacher and motivational speaker. She is PMI's Director of Business Development for the West Central Texas region, and an adjunct instructor with the Angelo State University Small Business Development Center, and teaches a variety of business classes to new and prospective business owners.