Modify Collection at Your Practice

January 23, 2018

Stay on top of your collection practices using training, technology, and communication.

Traditionally, practices have focused on the front desk collecting co-payments and have left co-insurances and deductibles to patient billing after the claim has been processed. This creates a lengthy revenue cycle and less cash flow for the practice. With more responsibility being placed on the patients for these deductibles and co-insurances, practices can no longer survive with traditional billing processes. Many are starting to deploy new methods such as requiring patients to pay up-front for services when deductibles have not been met. Modifying collection practices is a systematic change for your business with many factors to consider and processes to work through. It is essential to plan and prepare to launch new policies.

Determine Goals


Use data to determine if there is a need to modify your collection procedures. You may find there is no need to implement an entire new process for collections, but may want to consider new technologies to improve efficiencies or payment options to your patients.


Review your current policies and procedures. Does your process already include collecting deductibles and co-insurances? Perhaps there are polices in place that are not being enforced and simply require retraining staff and reinforcing the plan with your patients.


Review patient aging reports for A/R days and outstanding balances. If patients have balances that appear to be the entire cost of the visit, large balances or have a high number of days in A/R, chances are there is a significant amount going towards unmet deductibles.


If you feel changes are necessary, it's time to decide on an implementation date and which policies are you going to implement for your practice.

Work Flow


List out the steps for collecting at the time of service. Note what processes are already in place that will need to be altered, and which can remain.
Identify all the people who will be involved in the workflow and what they will need to manage their responsibilities.


Involve key staff in developing the new workflow; no one understands the job more than the people that are doing it each day. Having them become part of the implementation team will help them be more supportive of the program when it is rolled out.


If you are already verifying benefits prior to the visit, most of these systems will provide you with deductible information. Determine where this information obtained will be maintained in your management system.


If the desire is to collect co-insurances, obtain fee schedules for each plan and create a spreadsheet outlining your E&M Codes and top procedure codes.


Create Patient Policies


Communicating the expectations to your patients ahead of time is an essential part of implementing new workflow and strategies.
Making payment policies part of your registration packet assures every patient will have been made aware of your office process from the start.
Rather than create matter-of-fact policies, craft a brief message that explains the reasoning behind the policy whenever possible.


For existing patients, typically a letter from the Medical Director explaining the need for change and any plans for assisting patients can go a long way in the patient's acceptance of new policies.

Educate Staff


Prepare for the change by arming your staff with the tools they need to communicate the new plan; make sure they know where to find the information they need, are comfortable with answering questions from patients, and can navigate the policy for every-day workflow.


Provide scripting for the staff so messaging is consistent and is crafted with the tone you want to convey as they communicate with your patients.


Role play with your staff to alleviate their tensions in rolling out the new process. This makes learning fun, while showing them the best way to handle an uncomfortable situation or question from the patient. It also may uncover some areas that you haven't thought about addressing with the new polices.

Determine Payment Options
Requesting payments upfront is likely to be an unpopular policy for patients, but a necessary one for your practice. Developing options to assist patients with these payments can do a great deal to bridge the gap to meet everyone's needs.


Payment plans only work when patients adhere to their responsibilities and the staff can manage the complexities of overseeing the plans. Credit cards on file, written agreements permitting specific dollar amounts or processing limits gives both the practice and the patient some control over the payment plans.

Use Technology
Consider using technology to assist you by implementing an electronic credit card on file program. 


There are several secure systems on the market that do not display the credit card information and instead, store key information in the cloud. This provides a level of comfort that personal information is inaccessible to anyone on staff.


Charges are made automatically for dates and amounts that have been agreed upon during the initial set up with the patient.
Systems can provide a multitude of services from one-time payments, automatic payment plans, payment limitations and automatically sending receipts to the patient's email.


Modifying traditional collection policies is becoming more of a necessity and is gaining more popularity in the changing world of healthcare. Taking the time to review your process is an essential piece of keeping adequate cash flow moving through your practice.

Kathleen Adams is president and founder of MD Practice Partner, a national independent consulting firm that helps launch, develop and grow private medical practices. For more info visit: www.mdpracticepartner.com.