As an independent consultant, Betancourt now helps practices implement CCOF policies. Whenever transitioning to any new policy, practices should be prepared with an explanation, he says. “You have to anticipate that some changes might be a bit contentious, and train staff accordingly to make sure they can handle the issue.”
Beyond that, you must ensure that your practice is equipped with adequate cybersecurity to protect patients’ financial information, and that your policy complies with state laws and regulations, Hertz says. “Make sure that access to credit card information is very limited internally, and totally impossible externally. And notify the patient in advance of every draft being taken out or payment being made.”
Coastal Medical adopted a CCOF program last year after Boichat learned about it at a conference. She says that not only has it helped reduce bad debt, but also that patients have welcomed the convenience of not having to pay their bills manually.
Because insurance plans frequently change and credit cards expire, Boichat recommends making sure both are updated or verified as current at least annually as part of the check-in process.
Adopt helpful tools and technology
A few years prior, Coastal made a number of other changes intended to improve patient satisfaction, which ended up improving collections as well. For example, the practice added a kiosk to the waiting area so that people could check in on their own if there was a line at the front desk. “We really did it to improve the patient experience and our work flow process,” Boichat says. “What we didn’t realize was that the kiosk was collecting a lot of old balances.”
When patients checked in using the kiosk, the computer would remind them of their balances and give them the option to make a partial payment, she says. Most patients ended up paying off those old balances in full, a pleasant surprise to Boichat. Using tablets for patients to input their own demographic and insurance information can achieve a similar result, Betancourt notes.
Other useful times to remind patients of their balances are when patients call to make appointments and in appointment reminder messages, whether they be via voice, text, or email, she says. But perhaps the most powerful improvements have come with giving patients the ability to pay their bills online. This saves patients time from having to write a check and drop it in the mail. Plus, they can pay their bills from anywhere. “I’ve used the service myself and loved it,” Boichat says.
Don’t tiptoe around the money conversations
Finally, the cornerstone to making all financial policies and procedures effective is clear, up-front communication with patients.
“There’s always been the soft approach, which is the sign in the doctor’s office that says that copays are due at the time of service,” Tinsley says. In the age of increasing patient responsibility, he recommends upfront verbal communication. “Patients should know their financial responsibility before they even get in the car [to go to the practice],” he says. “With reimbursement continually going downhill, practices have to treat their office like a business, which it is.”
Practices shouldn’t feel the need to apologize for collecting patient balances, Betancourt says. “No margin, no mission.”
Goodbye, simple copay collection
Patients’ annual financial liability continues to rise. According to the 2018 Kaiser Family Foundation Health Benefits Survey, family premiums for employer-sponsored health insurance plans rose 5 percent from 2017 to 2018, with employees contributing an average of $5,547 toward a $19,616 premium. Meanwhile, annual premiums for individual coverage increased 3 percent, with workers paying an average of $1,186 toward a $6,896 premium.
According to the same survey, 85 percent of covered employees have a deductible in their plan, which averaged $1,573 for single plans, while 26 percent of all covered workers carry a deductible of $2,000 or more.