Your Front Desk’s Role in Reimbursement

December 8, 2017

Your billing staff handles secur­ing payment for the care you pro­vide, right? Actually, your billing staff finishes the job. Your front desk staff starts it by collecting complete, correct financial information from each patient — not to mention ap­plicable co-pays and deductibles.

Beyond being the positive, helpful public face of your practice, make sure your front desk staff handles its role in the reimburse­ment process by achieving these three objectives:

1. Collect complete and accurate insurance information for each patient.

2. Understand the details of your insurance plans’ requirements.

3. Pursue co-pays, deductibles and non-covered service fees at the time of service.

Insurance information. Include insurance information in your patient intake process. It can be part of your standard patient his­tory form or a separate sheet. Make sure it includes all these items:

*  Patient name                                  * Type of plan

*  Employer                                       * Major medical

*  lnsured’s name                               * Basic coverage

*  Insured’s ID or SS#                        * Deductible

*  Policy or Group #                            * Coinsurance

*  Plan effective date                           * Copayment

*  Authorization requirement                * Stop loss

Train your staff to call the plan right away if all these answers aren’t available.

Understanding plan details. If your staff understands its role in re­imbursement, it’s far more likely to perform it well. Even though your billers actually use the information, your desk staff must understand it enough to know why it’s important. Your manager or lead biller could lead a lunch-hour training session on the topic.

Pursue co-pays and deductibles. Back in the days of the $2 co-pay, you could argue that it wasn’t financially worth the effort to collect those small amounts — even though your managed care contract obligates you to do so. But co-pays are rising steadily as insurers and employers try to partially offset rising health insurance costs. There’s nothing unusual about $10 primary care co-pays or $25 for specialists. If a primary care doctor sees two managed care patients per hour, a $10 co-pay translates to $25,000 yearly revenue.

And once you train your staff to pursue these amounts — and your patients to expect the effort —they’re fairly easy to collect. You’ll still hear some of those I-don’t-have-­my-wallet-with-me excuses from some patients, but most will allow such an embarrassing situation to occur only once.

Instructing your staff to tactfully insist on payment trains patients to see you only when they really need care. It sends your staff the message that these dollars matter too. And don’t forget about those “non-covered services” that aren’t part of your managed care contracts.

Collection tools

Give your staff the tools to col­lect “up front.” That means your front desk people need enough small bills to make change, and the ability to accept credit card pay­ments. Keep a small fund, perhaps $75, in ones and fives at the exit station. Implement a simple sys­tem to reconcile and replenish the fund daily.

People will pay for almost ev­erything with credit cards. Don’t worry about the small amounts; a 3% credit card service fee on a $10 copay costs less than a stamp to mail the statement. Shop around for a credit card merchant — your bank should be able to point you in the right direction. Medical practices are good small-business customers for banks, so yours probably will give you a reasonable deal to set up an account.

As credit card use grows in your practice, consider “pre-authorized” charges for co-pays, deductibles and visits. Retailers with regular re­peat customers commonly use them. Asking your patient to sign the form on his/her first visit takes care of the collection hassle for fu­ture visits. Your staff can present this as a patient service benefit.

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