October 24, 2018

“Don’t worry, we’ll bill you after insurance pays.”

For decades this mantra has summarized the collections culture in most practices. But, with high deductibles becoming more common, patient A/R is growing. And the longer it ages, the harder it is to collect. That’s why modern practices ask patients to pay their full responsibility prior to surgery and at the end of the office visit.

Here are 9 best practices for implementing point of service collections.

1. Shift your mindset.

Collecting from patients “up front” is a philosophical change for most physicians and staff. For decades practices have waited for insurance to pay before billing patients. Asking patients to pay unmet deductibles, coinsurance, and non-covered services amounts before patients is an essential shift for point of service collections success.

2. Provide more clarity in written financial policies.

Update common, “old school” language such as “You are responsible for paying your financial portion of the bill” to more detailed information that distinguishes between payment types, and explains which specific services patients will be asked to pay. An example:

“If you have a plan our practice is contracted with, you’ll be asked to pay at the time of service. We’ll collect your visit copay plus any unmet deductible and coinsurance amount, up to the contracted rate, for office visits, X-rays, injections, and other treatments done in the office.”

3. Establish patient expectations when the appointment is scheduled.

Train staff to deliver this information in a service-friendly way:

“Ms. Carter, based on your symptoms, Dr. Winner will probably order X-rays. Your copay does not cover X-rays which, depending on the number of views, can range from $xxx – $xxx. We offer several payment options for you to pay this at the time of your visit, including automated recurring payments and CareCredit patient financing.”

4. Give the front desk data and tools so they know what to collect.

A big reason staff don’t ask for money is that they don’t know how much to ask for. We suggest organizing allowable amounts for your most common services and key plans into a spreadsheet. Calculate 20%, 30%, etc. of the plan rate to it’s easy for busy staff to quickly find the amount to ask for. Provide both a printed and digital version for staff to use.

5. Provide surgical cost estimates and collect a pre-surgical deposit.

The estimate should summarize and calculate the amount of unmet deductible, coinsurance, and non-covered services that are patient responsibility. Staff can obtain the patient’s coverage information for the recommended procedure by using insurance plan web sites or calling the plan.

6. Offer multiple payment options.

People are more likely to pay when they have multiple payment options. Instead of practice-managed payment plans, which are cumbersome to manage and often not followed, modern practices offer automated, recurring payments by credit card and patient financing in addition to credit cards. A few practices also offer text-to-pay and Bitcoin as ways to pay.

7. Let people pay online.

Essential for busy people and younger-generation patients, online bill pay is a home run for making payment easier. Contact your practice management system vendor about offering this on the patient portal. Or use an online credit card processing or e-payment company.

8. Collect past balances when scheduling follow up appointments.

Train staff to look in the patient’s account and ask for payment if there is a balance. Here’s a possible script.

“Mrs. Jones now that we’ve got your appointment scheduled, I noticed you have a balance of $168.50. I can take care of that over the phone today if you have your credit card number handy…”

Alternatively, staff can walk the patient through the use of online bill pay.

9. Train, train, train.

Asking for money doesn’t come naturally for everyone. Especially when it comes to asking high dollar amounts. Don’t assume that just because staff at the front desk have collected visit copays in the past that they will be comfortable asking patients for $350.

Create talking points and potential patient objections. Role-play various scenarios, assigning some staff the role of patient – then switch roles and repeat. Identify knowledge gaps and training needs and invest in staff education to build confidence and fuel collection success.

Download one of our Collection at the Time of Service Implementation Guides