Practice Management Alert

You can't chase every delinquent account, experts say

When a self-pay patient is behind on his payments, you can optimize the profitability of your collection efforts by knowing when to pursue him for the balance and when to drop the case.

Billers should ask self-pay patients for payment of outstanding balances each time they report to the office to see the physician, says Sarah F. Mountford, CPC, RCC, client liaison for Physicians Business Network in Overland Park, Kan.

-If I had a patient standing in front of me at the desk, I wouldn't hesitate to ask him for any amount he owed, no matter how small--while he is in the office,- she says.

Other experts agree with Mountford. -The best prevention to having a backlog of self-pay accounts receivable (A/R) is to collect what is owed at the time of service,- says Steve Verno, NREMTP, CMBSI, director of reimbursement at Emergency Medicine Specialists in Hollywood, Fla.

Suppose a self-pay patient calls for an appointment for an evaluation and management service, and you notice that she has an outstanding balance of $45 from a previous visit. Remind the patient of the balance while you-ve got her on the phone, and tell her that she should be ready to pay the E/M service fee and the outstanding balance when she reports. (Then, be sure to ask for the outstanding balance payment when the patient reports.) When to Send a Collection Statement If you cannot get payment during a face-to-face encounter, you should consider sending the patient a collection statement. Mountford says she would not send more than one letter for patients who owe $10 or less, -but this is going to vary by practice type. What works for a big group practice isn't going to be the same as what works for a small practice,- she says.

Best bet: -Evaluate your cost to send a statement (postage, paper, labor) versus your potential revenue- and then decide on each self-pay account individually, Mountford says. Consider Cost Before Phoning Patients Billers looking to track down delinquent self-payers should also consider calling patients, but you should  reserve the phone approach for patients who owe more than $50. (This amount might vary depending on your practice's size.)

Why? When calling patients, -your labor costs can quickly exceed the potential revenue. If you pay an employee $13 an hour plus benefits, and have them take 10 minutes to call a patient about a $10 balance, I think you are pretty close to losing money,- Mountford says.

-It's very important to keep collectors focused on high-dollar stuff first. Then, if you-ve worked every single high-dollar account, take a few minutes to weed through the low-dollar accounts,- she says.