Last June, MGMA-ACMPE released the results of a questionnaire that ranked members' most pressing practice-management challenges. In this edition of “Practice Makes Perfect,” we'll tackle No. 7 on that list: Collecting from self-pay, high-deductible health plans and/or health savings account patients.
Do you remember a time when you've sifted through a stack of paperwork for answers? Or another when you've asked someone for help while reading through a complicated document but they can't answer your question either? I'm sure you can recall how frustrating that can be. And that's the last thing you want your patients to feel when they interact with the practice or the staff. Providing a clear and thoughtful explanation of your collection policies and having staff trained to handle any questions your patients have can help them feel more satisfied about their visit.
Medical practices are increasingly collecting from self-pay patients. They are also working with patients who may have a high-deductible insurance plan, or maybe others who don't have insurance. This requires practice staff be knowledgeable and communicative about the organization's collection policy. It also requires an ample of amount of staff training. Here are a few policy and staff considerations for working with your patients on these matters:
- Develop a simple, broad statement that explains your financial policy, and distribute it to every new patient and post it on your website. The policy should define the patient's payment responsibilities, as well as the practice's billing and collections protocols, such as when:
- a. Co-pays, deductibles and co-insurance will be collected;
- b. The insurance company will be billed;
- c. Statements will be sent;
- d. Deposits are expected;
- e. Discounts will be offered;
- f. The practice will charge interest or assess late fees;
- g. Payment collection will occur (i.e. before or after the visit) and whether past-due balances will be collected in full or in part
- Have your patients review and sign a copy of your policy and be sure to retain a copy of the signed document in your system.
- Use your website and work with your bank or other sources to provide options for paying the balance due online. This is a convenient option for patients.
- Remind patients of their co-pays and/or balances due when placing appointment reminder calls. Also, determine a minimum balance necessary before making personal requests for payment. It may not be wise to call on every account, but it could be beneficial to call on accounts with a balance greater than, say, $100.
- Train your staff—not once but often—to ensure that they are aware of the issues at hand; chart their progress and communicate areas for improvement.
- Develop a collection policy. All items noted here should be written, agreed upon and given to the staff to use in their daily efforts to collect. This policy should go beyond just the patient balances and include the entire process of verification, authorization, claims submission, etc. In other words, define how the entire revenue cycle is managed.
- Offer employees scripts to use when communicating your policy to patients. Use simple, consistent wording. For example, “How would you like to pay the balance due?” “Will you be using cash, check or credit card?” “You have a small balance remaining; can we add that to your credit card at this time?”
- Monitor daily collections activities. Know how many patients with payments due have been paid in full. Note any discrepancies between what was due and the actual amount collected. Ask the staff to note instances when full payment was not received and why. This can become a training tool to address regular collections challenges. You can work through more “scripts” for patient interaction in the future.
An organized, thoughtful approach to patient collections that patients are informed of will improve your bottom line, but, more importantly, it will simplify the process for patients. Now is the time to review what you are doing and work together—physicians and practice staff—to achieve improved collections and increased patient satisfaction.
Medical Group Management Association