Keep Your Private Pay A/R Low and Your Income High

Collecting payments from patients can be a sticking point for your practice. Many providers do not want to get into financial conversations with their patients and many front desk staff are afraid of a confrontation if a balance is brought up. Of course, it doesn't help that most patients don't understand their insurance and receive surprise medical bills. Angry patient calls are considered par for the course for many. But, it doesn't have to be! Below are some guidelines and specific case examples to help start the money conversation.

Make sure your patients are aware of their benefits; encourage them to contact their insurance to check for coverage. If they have a high deductible, tell them! Your front desk staff should know this when doing eligibility checks and are capable of alerting the patient. Likewise, if they are seeing a provider for something that is not covered, tell them up front.

• Example A: a patient needs to see a Registered Dietitian for obesity related diagnoses but has an out-of-state plan with Blue Cross Blue Shield with no nutrition benefits. This patient will be responsible for the full billed amount, which you can provide ahead of time.

• Example B: a patient has a high deductible for all labs and diagnostic testing. They need an ultrasound following a mammogram to confirm what the radiologist sees. The mammogram is typically covered at no cost since it is preventive medicine, however, the ultrasound is considered diagnostic testing. Go over scenarios prior to the exam with the patient to ensure they understand all possible outcomes and are not surprised by a $700+ bill.

Make sure your patients understand your late cancellation and no show policies. Don't just give them a paper to sign; review it with them. Enforce your protocols.

Do not allow patients to accrue balances over a set amount. When they check in, your front desk staff should be telling them they have to make a payment on their account if it's over the set point. Have payment plans available for your patients, and make sure they adhere to it.

Ensure your front desk and billing staff have had de-escalation training for when they receive angry patient calls. Keep calm, listen and try to explain the balance rather than just refer them to their insurance. Offer a payment plan if the balance is high.

Make sure you are sending out monthly patient statements. If any are returned, contact the patient for an updated address. Only send to collections when absolutely necessary. Patients who are sent to collections will not return to your practice and may have harsh words even if they're in the wrong.

Following these guidelines should help with the A/R. Communication is always key, even if the topic is uncomfortable.

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