We've all encountered patients who feel that it is our responsibility (as healthcare providers) to provide the services and the insurance company's responsibility to pay for these services and they are exempt from ANY role regarding financial responsibility. Sure, some patients have that presupposed attitude upon presenting to our offices, but others are the result of poor management on our part. I have visited practices and heard for myself the dialogue that goes on at the front desk:
Receptionist: "Well, ok, you're copay for today is $15.00, Mrs. Jones."
Mrs. Jones: "Oh, you're mistaken. I don't have a copay with this insurance."
Receptionist: "No? It says here on your card that you do. So can you please pay that today?"
Mrs. Jones: "No, I really didn't think I have one so of course, I didn't come prepared."
Receptionist: "Oh."
~~~Silence~~~
Mrs. Jones: "Maybe you can bill the insurance company and if they tell you I have a co-pay, just send me a bill."
Receptionist: "Ok."
And out the door Mrs. Jones goes.
The patient was in total control of that conversation and I don't have to tell you all the things that went wrong, but will instead reinforce what needs to change to make it right.
1. First things first. Make sure you have the right person at the front desk. Not everyone has the personality to collect money and if the employee cannot manage the patient, you can be sure the patient will manage her/him! Select an individual who knows how to be IN control (but not controlling); polite (but not demanding); and knowledgeable (but not a "know-it-all"). Fit the right person to the right job and they will do it well.
2. Establish and adhere to written financial and payment policies - Equip your receptionist (or person handling patient collections) with the right tools to get the job done. If your practice does not have a collection policy, there can be no consistency. Make the time to write one and include in it your expectations concerning insurance, co-payments, deductibles, non-covered services, changes in coverage, non-payment, missed appointments (if there is a charge), forms and documents, etc.(SOS will share a sample collection policy for anyone who requests one - email [email protected] - to get you started.)
3. Strike while the iron is hot (or the pain is real) - Patients are much more inclined to pay for services when they are experiencing pain or have just been relieved of their pain...before they walk out the door. In fact, if a copay is all you need to collect, "train" your patients (by repetition) that this is collected upfront. You can put signs in your office that emphasize that "Payment is due at time of service" - but a sign is meaningless if you do not follow through.
4. Educate the patient - Having patients sign your payment policy does not guarantee their compliance; but a simple question..."Mrs. Jones, did you understand everything outlined in our payment policy? Do you need me to explain anything?" not only tells them this is significant but more importantly opens the door for questions and/or comments they may have. If a patient understands and is educated up front regarding their obligations/responsibilities...I find I have less of a struggle at the time of collection.
5. Have accurate data and information - It is helpful if your staff can verify their insurance benefits ahead of time, so that they are looked as well informed. They can pass this information along to your patients and respond accurately to their questions. Yes, it can be a very time consuming activity, but at the same time a valuable, pro-active exercise that can save headaches down the road. Advise patients that this is a service your office provides (again, it's up to you to educate them that you are only a third party in the patient-insurance relationship) and eventually, patients will respect and trust the information you make available.
6. Offer alternate methods of payment- If patients claim "I am not prepared to pay," or "I left my checkbook home" - you need to eliminate that mindset and create alternate options. Credit card payments are the #1 choice and if all attempts to collect on site fail, give the patient a SASE (self-addressed-stamped-envelope) for their convenience and request they mail the check as soon as they get home.
7. Make a little sign that says "CATOS" and leave it at the front desk to remind staff to ... collect at time of service! Incentives for increased collections might also be a consideration to keep their performance motivation at the optimum level.
