Improving patient Collections

Physicians’ office and medical billing companies employ various effective strategies to boost the medical insurance billing collections. In order to achieve enhanced collections and make practices more profitable, it is essential to focus on patient AR as well. But, there is a lethargic stance while working with patient receivables despite the fact that patient receivables contribute to a significant percentage of the total medical billing collections. Why is the goal of collecting patient dues often not achieved? Where do we lag behind? It is only the approach that needs to be changed when we work with patient receivables. A strategic approach and certain additional measures if taken while interacting with patients will help us in improving patient collections.

The doctor’s office should have a concrete ‘patient collections policy’ in place relating to different situations that might arise. This will act as a rule book to the patient collections process and will avoid any uncertainties and confusions with respect to patient collections. The practice should also ensure that this policy doesn’t deviate from the ‘state collection policies’ & ‘fair debt collection practices act’. Adding a clause in the brochures and in clinic’s information pamphlets will create awareness among the patients about the clinic’s payment policies.

The front office executives at the doctor’s clinic play a vital role in patient collections since they deal with patients directly. The executives should collect all required information from the patients at the time of the first visit. Designing a patient questionnaire that covers all necessary information would help a lot in minimizing errors with demographics.

Insurance eligibility verification plays a major role. Assumptions should be avoided and it is required to verify if the procedure will be covered by the patient’s insurance plan. Setting up expectation for payment is essential when the executive is not precise about patient’s payment responsibility.

Researches confirm that the number of patients with ‘heavy deductibles’ insurance plans has increased. Therefore, it is necessary to verify if the patient has insurance coverage, deductibles and previous balances once he/she is scheduled for appointment. Doing this prior to the visit will help the executives in getting a clear idea about the patient’s payment history if any. Executives should also collect the deductibles or balances from the patient if any at the time of the visit.

It is important to follow the ‘ABN policies’ and the patient should be given a clear idea that it becomes their responsibility to pay when there is no insurance or if the insurance denies payment. The patient should be aware of his/her payment responsibilities during the check out time. This is to ensure that there is no last minute surprise to the patient after getting the patient statement.

At times, it may be required to extend the ‘plan of care’ and the insurance carriers usually don’t pay more than the allowed limit. In such case, the patient should be informed in advance about the out of the pocket expenses.

Providing the executives with the apt software will improve the quality of the process and making efficient use of the software’s ‘patient collection attributes’ will deliver better results.

Sending comprehensive and customized patient statements with all necessary information like the service rendered, insurance’s payment details and patient’s payment responsibility will increase patient satisfaction as well as the possibilities for immediate payment. Attaching ‘inserts’ with guidelines to patient statement will help the patient in better understanding the bill.

Prioritizing is essential when handling the patient collections. The executives should have the ability to decide which patient account is to be given more importance based on the balance amount/ age of the receivables etc.,

It is required to send patient statements at regular intervals followed by a phone call. A phone call is more effective and by doing this, executives can confirm whether the patient has received the statement or not.

There should be an ‘address service’ agreement with a service provider having access with US public records, in order to find the current address of a patient, if there are return mails. •

Setting up of a separate department for handling patient queries and accepting all modes of payment like checks, credit and debit cards will enhance patient satisfaction and in fact collections.

In case of errors with patient information, correspondence letters could be sent out to patients for clarification and for avoiding any delay in process.

Providing flexibility in payment by putting forth payment plans will help patients- particularly self-payers, to pay their bills promptly. Moreover regular follow-ups will help in maximizing the collections and reducing the AR days.

Be it copay, co-insurance or self pay, following these guidelines accordingly will help in eliminating the bad debts and improving the patient collections.