Practice Management Alert

Because the cost of trying to collect by mail and telephone can quickly outpace the dollar value of the payment, you should collect all copayments up front. In addition, if your practice routinely fails to collect copayments from Medicare patients or contractual payers, you may be committing fraud.

Elizabeth Woodcock, MBA, FACMPE, director of knowledge management for Physician Practice Inc. in Atlanta, offers some advice on collecting copayments and deductibles:

1. Instruct employees to inform patients of their payment responsibility prior to the appointment. The most important step that physicians and their office staff can take to get their patients to pay their share of medical bills promptly is to talk to them about their responsibility. When employees schedule appointments and gather insurance information, you should also have them advise patients that copayments are payable when they come in for their visit.

2. Designate and train a specific staff person to discuss billing issues with patients. A lot of patients are not sure what their deductibles and copayments are especially when it comes to things like routine physicals or immunizations, which most health plans tend not to cover. The employee should discuss with patients what their copayments and deductibles are, how they are determined and remind them that they are responsible for paying them.

3. Give patients an estimate of what their bill will be. Billing staff should verify patients' insurance benefits when they check in for an office visit, then inform them what their health plan will cover and what they are personally responsible for paying. For surgical or multistep visits, staff should also give patients an estimate of their share of the cost and ask that they pay their portion by credit card at the preoperative visit.

4. Consider offering an installment plan. If a patient simply can't afford to pay all his or her bill at once, you may allow him or her to pay in monthly installments. If your physicians approve this method, make sure the cost of billing the patient each month isn't more than you plan to collect. For example, collecting a $5 monthly payment probably won't cover the cost of creating, printing and mailing the bill. $ $ $