Improve Outcomes with Patient Collections

Collect payment at the time of service.

With increasing deductibles, copays, and out-of-pocket patient responsibilities, collecting patient balances can represent a problem for practices. Collecting payments can be stressful, but it is important for your staff to be trained and proficient in securing payments from patients. Below are strategies you can implement in your practice to successfully deal with collections.

1. Set expectations. Create a financial policy for patients to sign and keep a copy at the time of service. Make the information available on your website and post a sign in the office. Your policy should be clear that payment is expected at the time of service.
2. Know what to ask for. It is best for your practice staff to pull the patient sheet for the day to be prepared to verify active insurance coverage, confirm benefit eligibility (if applicable to the services that will be rendered), and validate unmet deductibles or coinsurance. Review third-party insurance contracts to determine whether you can request coinsurance and/or unmet deductible at the time of service. Train check-out staff on how to look up the CPT codes to verify the amount due at the time of service per the beneficiary plan.
3. Asking for payment. There is no proven art to collecting payment, but the key is knowing how to ask. Staff should be instructed to request payment from patients, make eye contact, use the patient’s name during the conversation, and write out the receipt while asking how they will take care of the payment.
4. Accept a variety of payments. Allow patients to pay by cash, debit, or credit card. Accepting personal checks can be an option, but you should consider using a check-verification service to offset encountering bad checks. Don’t hesitate to set up payment plans and allow your patients to use a combination of payment options.
5. Preauthorized credit cards. Preauthorized cards will allow you to accept prepayments via credit card without encountering the hassle and danger of storing the patient’s credit card information. These systems allow your office to set up payment plans securely.
6. Collect deposits from self-pay patients. For self-pay patients—individuals without health insurance or those who opt not to file a claim with their insurance carrier—you can request a minimum deposit at time of service. Set the “deposit” as your full charge, a reduced flat rate, or an average of the copayment that would be expected of your commercially insured patients, but be consistent with this based on payments from new or established patients. You can create a financial-hardship policy to grant discounts based on the level of hardship. The key to making this work is to be consistent on charging deposits and to have a written hardship policy.Other self-pay policy options are:
   • Payment arrangement is made for the remainder of the fee, with a maximum of three equal payments;
   • If the patient is delinquent on the payment plan, it will result in interrupted delivery of services;
   • If the patient is delinquent on the payment plan three times, the account will be sent to collection and the patient discharged from the practice; and
   • The practice payment options are only cash and credit (this can be posted throughout the office).

   Whether new or established, your self-pay financial-agreement forms should be thoroughly explained to the patient and a signature obtained to acknowledge their understanding and receipt of the terms and conditions. Implementing a self-pay policy will have a positive impact on the amount of monies collected from self-pay patients on a daily basis in your practice.

7. Don’t forget the balance. Time-of-service collections include the amount owed for that visit as well as other outstanding balances from a prior encounter. Have staff print statements for all patients at checkout that reflect any payments made and any balance due. Giving patients these statements will reinforce your expectations of getting paid.

Once you establish a system that provides options that work for you and your patient population, consider the amount of statements you will send prior to transferring a self-pay patient account to collections. The “best practice” in the industry is to send three statements, typically sent monthly after monthly system closing. If no payment is received, make two attempts to call the patient to collect the balance. If all fails, transfer those accounts to a collection agency. Improving the collection of patient balances is predicated upon having a system in place to facilitate daily processes.