Practice Management Alert

Try collecting copays up front to reduce your burden later on

A small-practice biller can sometimes feel like a tightrope artist - walking the fine line between running a good business and upholding a good reputation within the community.

"Small-practice collections can be both a blessing and a curse," says Susan Billock, customer service manager with Certified Emergency Medicine Specialists PC in Grand Rapids, Mich. "The blessing is you see patients on a regular basis and have the opportunity to develop" a good relationship with them, she says. Yet tricky situations arise when you have to resort to an outside collector in a community where word travels fast, she adds.

 Use these five time-tested tips to improve your collections success:

 1. Prevent overdue balances on the front end. Have a clear-cut financial policy that tells patients what you expect from them with regard to payment, Billock says. For example: "Payment of copays is expected at time of service," and "balances after insurance must be paid within 90 days," she says. You should also include what fees you will charge for returned checks, form completions, no-shows, etc.

Copays are key: Collect all copays up front, says Laura A. Bassett, office manager with Mid-South Surgeons PLLC, a two-physician surgical practice in Columbia, Tenn. "We've cut down on a huge volume of our collections now that we don't have to bill patients for their copays," Bassett says.

Arrange payment plans early: The biller responsible for collections and A/R should discuss any outstanding account balances with a patient at check out, Billock says. "You can get more cooperation from patients while they are in front of you than you can over the phone," she adds.

 2. Discuss your collections policy with your physicians. The biller handling collections and A/R should sit down with the doctors to discuss how they want to handle patient accounts, Billock says. Ask how aggressive you should be in collecting balances - this conversation will ensure you aren't using collection methods the physicians disagree with, she says.

 3. Try pleasant phone call reminders first. Sometimes all a patient needs is a gentle reminder that his account is overdue. "Make sure you actually talk to the patient" and don't just leave a message asking him to call you back, Billock says.

Be flexible: You may have to adjust your work schedule so you stay until 6 or 7 p.m. one or two days a week. This extra time will allow you to catch patients who aren't accessible at work during the day, Billock says.

 4. Stick to a standard collection process. "Our patients go through three letters and a phone call in-house, then we send them" to an outside collector, Bassett says. If the patient still hasn't paid by the time the outside collector is about to initiate legal action, "We usually release the patient from the practice," she adds. There's simply no reason to keep treating a patient who has not paid for past services - no matter how guilty or obligated you feel.

 5. Use an outside collector. You may feel uncomfortable about using an outside collector for patients your practice knows well, but the simple act of involving another party is often enough to get patients to pay.

 Want special services? If a bigger collection agency doesn't offer some of the small-practice services you want, such as collecting on older and smaller balances, try using an individual outside collector, Billock says. He may be more willing to work smaller balances and flexible hours, and cater to any other specific needs.

Tip: Your practice might want to consider bonus incentives for an individual outside collector based on dollar amounts and the age of the account. This principle could also work for a collector within your practice.