6 ways to salvage the patient balances you've already written off

Every practice has one report nobody opens. It is the aged patient accounts receivable: the balances that survived the statements, the phone calls and the payment plan offer, and now sit in the 120-day bucket waiting for somebody to decide what to do with them. Providers are collecting roughly 30 percent of the patient portion of claims after insurance, according to Kodiak Solutions data reported by HFMA, and that yield slipped again in the first quarter of this year even as point-of-service collections improved.

What sits in the pile has changed. Bad debt is no longer driven by uninsured patients coming through the emergency department. More than half of what providers write off now comes from patients who have coverage, and collection rates from commercially insured patients have fallen for several years running, HFMA reported. These are people with insurance cards, deductibles they did not plan for and balances the practice already earned.

The leverage practices once relied on has changed too, and most of the advice in circulation is about preventing balances from aging rather than dealing with the ones that already have. Working the aged pile well is an exercise in triage and arithmetic, not pressure. Here are six places to start.