Practice Makes Perfect: Collecting patient balances requires support and effective processes

In June, 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,” we'll tackle No. 7 on that list: Collecting patient-due balances (self-pay, high deductibles and health savings accounts).

My uncle told me when I was growing up that “pennies add up to dollars,” and taught me the true value of tracking and saving even a small amount of money. I encourage medical practices to embrace this philosophy, especially when developing processes to collect from patients. Every “penny” that a practice collects has a downstream effect. Physician practices are, after all, a business, but this “business” extends beyond just dollars and cents. Healthcare organizations are also in the business of taking care of people.

Here are six ways to manage collections by developing and implementing effective processes, while supporting your patients.

• Staff your front desk with employees who are comfortable speaking with patients about the collection process and their financial responsibilities.
• Devote time to train front-desk employees on how to approach collection policies with patients, as well as on how to understand the ins and outs of patient balances in the practice-management system. Medical practice staff are a resource to patients, and should be trained to address any questions that may come up during the collection process.
• Train the medical practice staff on the various insurance plans that the practice frequently sees. Spending time on the front end to understand the intricacies of many insurance plans will save staff time, while also saving patients time and frustration in understanding their deductible and what is covered. If you don't have access to real-time claims adjudication with certain payers, ensure that your billing staff checks with the payer prior to a patient visit for which a surgery or major procedure is arranged.
• Consider offering payment plans or other methods of working with patients to collect balances. Make an effort to work with your patients to assist them in meeting their obligations. Patients may not know the amount of their deductible or how much of it they've met. Spend time with patients to educate them about their plan and coverage.
• Ensure that your practice has clearly articulated financial policies. With a number of high-deductible plans available to consumers, it is increasingly important that practices address payments for procedures early on.
• Keep the collections process and the clinical visit with the physician completely separate. Establish the medical practice staff as the resource for handling questions about billing and collections.

Medical practices must be truly patient-centric, even when it comes to financial matters. Understand patients' issues and needs. Practices should work to provide clear information about health plans, payment expectations, billing procedures and payment options. Practices must take an active and supportive role in working with patients from both a clinical and financial perspective.

Kenneth Hertz is a principal with MGMA Health Care Consulting Group.