Boost Medical Practice Collections by Cutting Down Patient Statements

October 19, 2013
P.J. Cloud-Moulds

Are patient statements out of control at your medical practice? Here are some tips to clean those up and get paid what you are owed.

Do you know how many patient statements are sent out at your practice? Do you know how high that A/R class is? These are two very important questions you need to ask yourself today. The numbers might shock you.

If you do find that the number of patient statements is too high, you can then start asking why this is the case. Here are some of the common reasons:

Your front office staff did not collect the patient copay, coinsurance, or deductible. If you have an up-to-date fee schedule, calculating the patient coinsurance and deductible is easy, and should be done at the end of the appointment prior to the patient walking out the door. Copays are easy to collect and should be collected at the beginning of the appointment.

Your front-office staff did not collect according to plan details. When verifying an insurance plan, sometimes the insurance company will provide incorrect information. Your staff may also be calculating the patient portion incorrectly. Be sure your staff is well trained in this area. It's costing you a lot of money if they are not.

Patients are paying at the time of service, but those payments are not getting posted properly. This results in a nasty call from the patient stating that, “I paid, and will not pay again!” This is the epitome of poor customer service. Institute checks and balances at the end of each day to ensure payments are posted.

Patient “forgot their checkbook or credit card.” This is a line that you hear too often, and it's full of hot air. If the patient “forgets,” let him know that he can call in his payment by the end of the day, or he will incur a late payment fee. Yes, this is legal. If the patient can't pay now, he certainly won't pay in a month when he gets the bill.

Staff adjusts off a patient deductible. Your front-office staff performs the insurance verification, and sees that the patient has a $5,000 deductible of which only $352 has been met. Once the deductible is met, the patient is responsible for 20 percent of the allowed charges. Your front-office staff is reluctant to charge the patient the deductible amount for fear of being yelled at by the patient (who should already know her plan limitations, but most often does not) so staff charges her the co-insurance instead. This results in the patient getting a bill for the remaining amount. The angry patient then calls and yells at the staff stating, “I paid at the time of service!” Another example of poor customer service. Remember, you cannot adjust off a patient deductible.

The patient has Medicare and a secondary insurance. Since we are not allowed to collect monies from Medicare patients until Medicare pays its portion, we bill the secondary. If the secondary does not pick up all of Medicare's 20 percent, then the patient gets a bill. It's really difficult when some Medicare patients do not understand their secondary insurance has a deductible, or will not cover the entire 20 percent.

Just sending out statement after statement is a very poor way of running a business. Have a time limit of how many statements you will allow a patient to receive. Three months is a good rule of thumb. If patients need to be put on a payment plan, that's great, but put a time limit on that, as well. Your practice is not a bank, credit union, or credit card. It is a business, and no other business would allow goods and services to walk out the door before payment. Stop allowing patients to take advantage of your good nature.