In July 2008, the Medical Group Management Association released the results of a questionnaire that ranked members most pressing practice-management challenges. In this edition of Practice Makes Perfect, well tackle No. 9 on that list: Collecting from self-pay patients or those with high-deductible health plans and/or health saving accounts.
With the continued growth of high-deductible health insurance plans and health savings accounts, medical practices must increasingly rely on front-desk personnel to collect from patients. Some patients understand the need for front-end collections, but many hold onto the idea that the practice will bill the insurance and let them know later what they owe. Sophisticated practice administrators know that collecting those co-insurance amounts and deductibles is an important part of keeping the practice economically healthy, especially now.
Recognize that changes in front-desk procedure will require significant, repetitive training. But even before that, you must develop a matrix to help employees to quickly get the information they need. Make a grid reflecting the health plans that cover 95% of your patients. Be sure to include each plans variable components, such as co-insurance, deductible and services that require pre-authorization. Then, plan by plan, create a list of phone numbers for staff to verify coverage and amounts. Be sure to include examples of plans insurance cards and highlight the pertinent information.
Make sure that everyone who works at the front desk understands how a high-deductible insurance plan differs from an HSA and how to tell, by looking at the patients insurance card, exactly what the co-insurance and deductible amounts are. Teach your employees to be definitive and firm about collecting. In the best practices, the person responsible for collections will know what is due from a patient before he/she approaches the desk. After checking the patient in, a front-desk worker should say: Mr. Patient, your copay/co-insurance/deductible is $XX. How would you like to pay for that? Be prepared to accept cash, checks or major credit cards.
These practice procedures will markedly increase your upfront collections. What is left? Three things:
- Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% paymentsone today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
- Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
- Provide professional signage that states your basic policy: Payments are due at time of service. Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.
Good collection starts at the front desk.
Shannon DoyleIndependent consultantMGMA Health Care Consulting GroupEnglewood, Colo. Submit a letter to the Modern Physician Reader Blog. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.