Four Patient Payment Collection Mistakes to Avoid

September 11, 2013

A pathology lab's collection process reveals big mistakes other medical practices can learn from.

A local pathology lab has resorted to a collection agency to collect $13 from me. It has been an interesting experience to be on this side of a medical provider's attempt to get paid.

The situation has revealed some big mistakes the pathology lab made that I think any health system can learn from:

Mistake #1: Failing to confirm and update patient information. The patient address associated with the unpaid balance has not been current for five years. My best guess is that the lab got it from a dermatologist I saw six years ago. My internist, who I did not know when I lived at that address, is supposed to have ordered the services at issue. She could not have supplied the bad address.

Mistake #2: Failing to update the address - twice. The lab probably matched the name and date of birth on the orders with its database, and did not check to see if the address on the orders matched their system. While failing to check the address is not the best policy, it may have made sense for the lab to skip this step if its experience is that addresses match up more often than not (returned mail would identify bad addresses).

Once the initial invoice was returned, the lab should have gone back to the internist for a current address, used the phone number to look up a current address, or called me. What it probably did was continue to send more statements that were also returned, incurring significant costs relative to a $13 charge and generating no revenue.

Mistake #3: Failing to collect as soon as possible. Credibility, more than the time value of money, is the issue in this situation. The service is supposed to have been rendered in early 2011. The first I knew of the bill was mid-2013, when I received the first automated collection call. I have no idea to what this charge relates, and I am suspicious that it might be in error because the long lag period calls the lab's billing reliability into question.

Mistake #4: Failing to provide the patient with necessary information. The collection calls are recorded and cryptic. They give an opportunity to transfer to an operator, but in all but one instance I have had to hang up before anyone actually came on the line.

The recorded calls do give the name of the biller, so I tried calling the lab directly. It's a big operation with lots of offices but there is no listing for a business or billing office. I left a couple of messages at different numbers and have yet to receive a return call.

Once, I actually spoke to a person. She told me the referring physician, the date of service, and the amount due. I asked her to send me a copy of the original invoice so I could pay it.  She said she had no access to that information. Apparently, the entity trying to collect the fee cannot send me the information I need in order to be assured I owe it.

It would not be hard for the lab to have a number or e-mail for billing inquiries. Of course, the collection agency would want credit for any funds materializing, but that could be handled by supplying a specific number or address that only come from the collection calls.

We are now at an impasse. I won't pay the bill just because some random caller says I owe it, and that's all the collection agency can do. Having learned to recognize the collection agency's phone number, I don't pick up their calls.

The lab and the collection agency have spent money and other resources way out of proportion to the sum they are trying to collect, and they have wasted a lot of my time. All of that could have been avoided - and the funds collected - if the lab had done some very simple things to handle the account better in the early stages.