Improving physician practice collections

The toughest payers to collect from, though, are not commercial insurers or federal programs, but your own patients. For that, you need good practice policies — and a determination to follow them. When it comes to patients and payment for services, the key is simple: accountability, on both the patient's part as well as practice staff.

Careful attention to time-of-service collections is the most important aspect of getting paid by your patients because it’s your best chance of getting what you’re owed and it reduces your A/R. The goal at time of service should be at least 90 percent of the payment. One way to increase time-of-service collections is to accept every reasonable form of payment, especially debit and credit cards. The more money you collect upfront with patients and their families, the better your receivable cycle and the more money you’ll generate for the practice.

Working with staff on proper communication and collection of payments is critical and essential as the economics of physician practices are probably worse now than they’ve been at any time in history that we can recall. Payment needs to be an understanding between staff and patients handled professionally and with documented policies. Patients need to know when you come here, we want to provide the best service possible, but there are fees for those services – it should be an expectation and part of the professional business culture as it is critical to the success of the practice.

You should also focus on issues beyond the copay — reducing the cost of sending statements with follow-up letters to patients and the need to hire collection agencies, who take a portion of the outstanding A/R. While collection agencies are perfectly appropriate for the industry … it is really not a patient satisfier to send someone to collections. Those patients would like to settle their bill, if done in an appropriate fashion. To achieve the same results in your practice requires training of staff and possible tweaks to your billing system, but having a firm grasp on what is owed to your practice is just as important as knowing your patient mix.

Some practices consider sending patient statements a "routine part of their business," but it shouldn't be. A patient should get a 30-day notice to pay, then a 10-day letter, advising them of a window for them to reach the practice to discuss the outstanding debt. Only if there is still no contact should the patients be sent to collections. Anybody who doesn't give a courtesy phone call is not going to pay in a timely manner, so send those people to collections and be done with it.