Show Me the Money:

Patient Collections in a Dicey Economy

Anyone who has sat in the lobby of a medical office is well aware of the awkward moment at the window when the receptionist is attempting to collect for medical services rendered. The uncomfortable exchange typically ends with an agreement to bill the patient at a later date.

Most medical practice consultants roundly disapprove of this system and emphatically encourage collecting fees at the time of service. In fact, many offices have gotten into the habit of collecting copayments prior to seeing the physician. It is further recommended that clear signage is in the lobby concerning payment expectations as well as reminding them at the time that the appointment is made, “It is our office policy to collect copayments or outstanding balances prior to being seen by the physician”. This simple extra step can work wonders.

For tertiary providers such as radiologists, pathologists or anesthesiologists, collecting at the time of service simply is not an option due to the nature of their business.  In those cases, billing post-service is par for the course.  Further complicating matters for these specialties are their inability pre-service to determine the patient’s correct health-plan and associated financial responsibility.

With many states facing double digit unemployment, foreclosures on the rise and general financial panic abounding it seems that getting prompt patient payment for medical services is a nothing more than an urban myth. If the choice for some of these individuals is food on the table versus a CBC from a year ago, the medical bill will remain unpaid.

The key to effective medical collections is, simply, not to let the balance go to collections. The decision to send an account to a collection agency is an individual preference per medical practice. And once the bill is sent off, the physician is likely to see only a small percentage of those funds ever returned to them.

To avoid that, offices should make every effort to collect from the patient on their own. This can mean a personal, empathetic phone call to the patient. It can also mean working out an extended payment plan. For those who have no insurance or are under-insured, the physician may want to take a deep discount on their charges which brings it down to at least Medicare level. In the midst of these collection efforts, it is a sound policy to operate with compassion and understanding, in lieu of hostility and unrealistic demands.