Billing & Collections

Are medical practices more or less likely today to offer patients a payment plan to help them cover their increasing out-of-pocket costs? Such doctor-arranged payment plans would have significant advantages for so-called “self-pay” patients, many of whom charge out-of-pocket costs on high-interest credit cards.

I just got a refund request from a payer. It’s for close to $1,000 for a patient we saw from 2004 to 2007. The payer now says the patient wasn’t eligible then. We checked, and it turns out the patient actually was on a Medicaid managed care plan and was not with the payer we billed. Still, Medicaid won’t consider claims from 2004. I just do not know what my options are. Are there any regulations to prevent this?

Appeal Letter Justifying Fee Schedule as Fair and Reasonable

Assignment of Benefits

Here is a sample collections letter to use at your medical practice.

If you can't verify a patient's insurance, their signature on this form shows they know they are responsible for payment.

One partner wants to retire; the other two want to buy him out. The only problem: They can’t agree on the terms, and things are getting heated.

Of all Wal-Mart’s innovations, the most surprising is its plan to sell EMRs off the shelf. Few private practices use EMRs - most cite cost as the biggest hurdle. Can Wal-Mart really make a difference?

How is the recession likely to affect your practice? And what can you do to soften the blow?

Playing the market without a broker is risky. Is it worth the gamble?

I have a new practice. We have been open for three months now, and I am finally starting to see insurance payments come in. What benchmark should I use to see if we are in line with other offices?

The practice I currently work for has always billed Medicare exactly what Medicare pays. Is there a downside to doing this? Does Medicare place you in another pay bracket? It does keeps the A/R lower than if we charged our fee schedule, but I want to make sure it does not have negative consequences.

I started an urgent care clinic. The insurance companies will not recognize us even though I have gone through the expense to make the facility equal to a small ER. How do I get acceptance from the insurance companies?

This time, it's back with a quality twist.

What kinds of insurance do you need - and how much? We answer the eternal questions.

If you accept credit cards, and you should, you’ll want to be aware of these hidden fees that card processors charge.

An in-demand psychiatrist needs help leveraging his popularity for a more appropriate fee schedule.

The results of our annual fee schedule survey tell you how much to expect from payers. The news isn’t good, but we have plenty of advice for making the most of difficult times.

A soon-to-be partner wonders who should pay for an office makeover necessitated by his promotion.

You may not feel wealthy, but a six-figure income makes you vulnerable to threats. Here’s how to protect yourself.

The economy is deteriorating. And healthcare is no longer “recession proof.” Here’s your guide for getting through the worst of times.

Each issue we’ll help you steer clear of hidden pitfalls. This month: Your favorite employee is sweet to you and patients, makes the World’s Best Brownies, and never takes a vacation. But is she robbing you blind?

Patients are looking for ways to cut expenses, just like you. Here’s how to help them balance their health needs with their financial challenges.

Our physician-focused personal finance column returns by popular demand. This month: How to build just the right team of advisers.

Few things in medical practice can cause as much rancor as the development of a new physician compensation plan. Divvying up limited revenue bruises egos and leads to charges of unfairness - especially in oncology, with its numerous subspecialists of varying income expectations. Better know how to do it right.

Think pediatricians don’t have any clout? Think again. Learn how practices like yours got more from payers.

There’s encouraging news in our third annual Physician Compensation Survey. Primary-care docs are seeing their incomes tick upward - on average. Where do you stack up?

A medical-malpractice insurance company says it will offer discounts to cash-only and concierge-style physicians. The reason: They’re less likely to be sued.

You’d like to reward good employees with above-cost-of-living raises every year, but you can’t. Here’s our advice on how to keep loyal staff on board without overpaying.

If you’re trying to go broke, our list of common money-losers will get you there fast! We can show you how to tighten those nuts and bolts, and stem your cash drain.