Practice Management Alert

If you have many patient bills and insurance claims outstanding month after month, it may be time to prioritize your collection process. The first step to solving your collection woes is to try to avoid having the problems in the first place.
 
The best time to begin the collection process is before the service is rendered. Practices should verify the patient's insurance deductibles and coinsurance amounts and get a commitment from patients on how they will satisfy their financial responsibility, experts say.
 
"There's a lot you can do to avoid having to go through the collections process," says Catherine A. Brink, CMM, CPC, president of Healthcare Resource Management Inc. in Spring Lake, N.J. "I like to tell patients up front that they are going to be responsible for a specific dollar amount, and ask how they intend to pay it. This works especially well for surgical specialties because when you precertify your patients for a procedure, you're going to find out what the coinsurance is. For example, if the insurer pays 80 percent and the patient pays 20 percent of charges, you will know before the surgery that if your charge is $3,000, the insurance company is going to pay $2,400 and the patient, $600. You can start the collections process right then by trying to get the money before the fact, rather than on the back end."
 
Some surgical practices prepare formal written cost quotes for their patients to inform them of what their insurance company will pay and their personal financial responsibility for the upcoming procedure, and ask for a deposit on the account, if not the payment of the patient portion in full.
 
Note: For more on cost quotes, see the article, Avert Patient Payment Troubles With Surgical Cost Quotes, on page 13.
Send Your Bill the Day the Insurer Pays
If the patient's responsibility hasn't been met by the time the insurer has paid its portion of the bill, the practice should begin pursuing the patient as soon as it posts the insurer's payment, Brink says. "When the insurance company has paid the doctor, the patient is informed of that. The patient receives an explanation of benefits from the insurance company before or at the same time as the doctor is paid. So, the patient will know the exact amount owed. The practice's bill should go out to the patient the same day as the payment is posted," she says. "If you wait, it's likely the patient will procrastinate."
 
If you've billed a patient once and not received a payment in 30 days, it's a signal that you may have a problem collecting that bill. Many practices send two or three additional statements in the hopes the patient [...]