Tales from the Front: Deposits and Deadlines

In recent consulting visits we’ve discovered two disturbing trends dealing with a practice’s financial policies.

Observation on deposits: Patient coordinators, their managers and physicians are NOT paying attention to long established, sensible rules about deposits.

Plastic surgery patients should make a deposit before their name is placed on the surgery schedule. The amount should be commensurate with the overall cost of the surgery.

Our recommendation: Use flat amounts that increase incrementally based on the total cost of the surgery. For example, $500 for a surgical fee of $5,000 or less; $1,000 for surgery under $10,000, $2,000 over $10,000.

Many of you have asked why we don’t advocate percentages. The reason is twofold.

1. Multiple procedure cases, or those more complicated in nature can quickly lead to accounting aerobics. When the patient says, “What if I add this? What if I don’t do that one?” You could potentially be recalculating the whole price and deposit again and again.

2. Flat amounts are easier to spot on deposit slips, pre-payment reports and Accounts Receivable reports.

Observation on balances: Balance payments are not being collected or, they are being collected too late.

What happens when a 4 hour case cancels a week ahead of time—and the balance wasn’t due until 7 days prior? Even if you could find a willing patient to fill in, they would probably not meet the strict pre-op guidelines regarding aspirin, etc.

Our recommendation: OR time is a precious commodity. Sloppy staff work and managerial inattention are a deadly combination. The old rule for collecting balance payments was traditionally two weeks or 10 working days before surgery. We now recommend 18 to 21 days before surgery to stem the tide of thoughtless, casual-minded patients who change their mind at the last minute. Certainly, you would establish and enforce this policy for cases that are 4+ hours.

1. Be sure the staff knows how to use the pop up reminders and alarms that are part of NexTech, Inform and even Outlook. They will know who owes money as soon as they turn on their computer.

2. If you are a manager, better check that new employees really understand how financial policies affect the productivity of the practice.

Physicians—remember these words of wisdom: “Trust and Verify.”