Per the MGMA, the average individual deductible now is around $4,300 and family deductible are around $8,300. This increased deductible on many plans has increased patient out-of-pocket expenses by 230% in the last ten years. The MGMA estimates that 10% of a practice revenue is in patient AR over 60 days.
There are many articles out there about why it is important to collect patient balances – many quoting the above statistics, so I don’t want to repeat the obvious and probably overstated.
Instead, let’s look at some ways that we, as a billing service solution for providers, work to resolve this matter.
H A R D C O N V E R S A T I O N S
I have found that most of my fellow Associates at OCMS do not like contacting patients regarding outstanding balances. They are hesitant to be ‘Bill Collectors’ and make those important calls to ask people to resolve their balances. However, this is such an essential part of the practice revenue, we make this a priority training piece.
What I have found when I call patients are some hard-luck stories, sometimes yelling, but most of the time, when I actually reach a patient, they are very understanding, know they have a portion that is their responsibility, and are willing to pay.
What I have found when I call patients are some hard-luck stories, sometimes yelling, but most of the time, when I actually reach a patient, they are very understanding, know they have a portion that is their responsibility, and are willing to pay.
There are different ways to deal with the yelling and hard luck stories that I will address in another post.
I T S T A R T S W I T H T R A I N I N G
Here is what I tell my staff to encourage and guide them to appropriate collection efforts:
1. First and foremost, you must be kind, friendly and professional – we are an extension of the provider, being aggressive or timid and apologetic are ineffective and can damage provider relations with the patient.
2. A balance is owed. Period. This is just fact – not emotion. Patients receive an Explanation of Benefits that should mirror exactly what we are sending them. If they question this, I have my staff refer them to their insurance for clarification. After all – this is THEIR insurance, not ours. We do not know what plan they have signed up for, and it is their responsibility to understand it, not for us to explain it to them (although, I have spent many hours helping patients understand the difference between copays, coinsurance and deductibles).
3. Always use the word “May” in lieu of “Will” when telling patients about potential collections (“You MAY be referred to a collection agency”, as opposed to “you WILL be sent to collections”)...this leaves you an ‘out’. Saying MAY does not commit you and gives you options. Saying WILL commits you, and you have no option but to do what you say you will do.
4. Remember – Be ‘matter of fact’, not apologetic…when a patient goes to a doctor or other healthcare provider, they KNOW they will be responsible for a balance. The patients are prepared and expecting this. This is true, even if they can’t pay all right now, or disagree with the insurance company processing, or have had a bad experience at the office.
5. Be consistent. Whatever you do, be consistent. This includes sending patient statements, making calls and sending patients to a collection agency for hard core collection efforts. If your patients know that you will never send them to collections, they are less willing to cough up their portion.
6. Don’t let emotion hang you up. I find that I cannot put our fellow Associates on just patient collections for very long. It gets tiresome and emotional. Break it up into chunks. This works great if you send statements once a week, for example, rather than once a month. This allows our Associates to make calls on a smaller volume per week, and keeps patients balances truly current.
Don’t let emotion hang you up. I find that I cannot put our fellow Associates on just patient collections for very long. It gets tiresome and emotional. Break it up into chunks.
7. Whether sending statements electronically or manually, you should review the patient statements, and determine who has had three or more (this is our standard policy), then make that final call to the patient in a last attempt to collect the balance.
8. Always offer a professional tone when speaking with the patient. Until you know all the facts, give the patient the benefit of the doubt. Even if the patient’s behavior seems ‘over the top’ you should always maintain a professional posture. Your interaction should never be sarcastic, surly or condescending.
9. Send the patient to a collection agency. I cannot emphasize this enough. Your patients must know that you are serious and expect payment for services rendered.
Our Associates defer to what the provider wants regarding patient collection policies, however, we encourage our providers to allow us to follow the steps listed above as we are committed to collecting everything possible for them and decreasing the 10% statistic in the over 60-day bucket.