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Five Ways to Get Proactive About Patient Collections in the New Year

Cost-sharing insurance models are here to stay and patient responsibility is an ever-increasing part of your overall reimbursement. A study published in the APTA’s journal PTJ in June of 2015 stated that an average out of pocket responsibility for a plan of care was $351, or approximately 19.5% of the total cost of care.  The question for any therapy practice is – how do I collect that portion from my patients? 

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Five ways to be more proactive about patient collections.

  • Know the difference between types of cost sharing:
    • Copay: A fixed amount due by the patient at the time of service.
    • Co-Insurance: A percentage of the allowed reimbursement amount, based on the CPT codes billed.
    • Deductible: An annual amount due to be paid by the patient before insurance begins to pay.  This is also based on the allowed reimbursement amount, based on the CPT codes billed.
  • Make sure that your patients are aware of their financial responsibility for treatment.  It will surprise no one who has been in charge of a therapy practice for any length of time that many patients have no idea what their benefits cover.  Making sure that your team is proactively verifying patient benefits before their first date of service (and again before their first date of service in the New Year) is vital.  Having a process to notify those patients of their benefits and offer payment plans if necessary can dramatically increase your ability to collect patient balances at every visit.
  • Make sure that your front desk team knows how to view patient balances and is prepared to ask for money when the patient checks in. Only rarely will patients offer to pay without being asked, and generally only if they have a co-pay that they are aware of.  Your team needs to be coached on how to calculate deductibles or co-insurance for every patient visit.  If they are not able to do that, you should develop a flat-rate policy i.e. collecting $10 for a patient with a 15% co-insurance and have them sign a financial acknowledgement that they will be required to pay the balance upon receiving a statement.
  • Ensure that your team is coached to overcome any common patient objections. Asking patients for money can be awkward and your staff may not be comfortable pushing back on a patient who is unwilling to pay.  Role play in staff meetings, or invest in sales training for your team.
  • Make sure you have a back-end collections process in place. Inevitably, there are going to be uncollected balances and you need to know how you’re going to pursue them.  How many statements do you send to your patients before you engage in the next level of collections actions?  Do you have designated staff responsible for outstanding patient collections?  What is their process?  Do you work with a collections agency?

While it may seem difficult to collect money from patients, no one can afford to lose almost 20% of their revenue.  The better-prepared both you and the patient are, the more likely that you will be able to both collect what is owed to you and retain a happy and referenceable patient.

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