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Patients expect to receive healthcare, but don't always expect to pay at the time of service
Photo by Karen

It affects a medical practice's revenue every day: While patients still expect high-quality healthcare from physicians and prompt service when they come to your practice, they don't necessarily expect to pay upon arrival – or departure.

This layaway tradition – buy now, pay later – appears to have only worsened during the economic downturn. Many patients have lost their insurance, or they've had to accept higher deductibles and copays.

A March 28, 2009, Health Affairs study projected that nearly seven million Americans will lose their health insurance between 2008 and 2010 due to the recession. And in MGMA's 2009 Medical Practice Today research, medical practice administrators ranked "collecting from self-pay, high-deductible health plan, and/or health savings account (HSA) patients," as the fourth biggest challenge in their organizations.

HSAs create complications for your practice and its patients because the plans operate differently than standard managed-care plans. For example, some HSAs manage the employee accounts and send the payments to the practices. Other plans require the medical practice to send a bill. While you may understand the process, patients may not, resulting in delayed payments and time spent answering questions by your staff.

Fortunately, you can do several things – universal to all medical practices, no matter the specialty – to increase collections while a patient is in your office. You'll find these tips in MGMA's guide to Accounts Receivable and Collections, part of Lessons for Financial Success, a series of free online tools developed by the MGMA Center for Research and funded by the United Health Foundation.

11 tips to increase collections

  • Gather all patient information at the time he/she calls for an appointment
  • Update each patient's payment information at the front desk at every visit
  • Establish and communicate the expectation that patient balances are due at time of service
  • Collect all copayments and deductibles when the patient checks in
  • If the patient doesn't pay at check-in, remind him/her at check-out if he or she needs to pay any of the cost
  • Work with patients who owe past-due amounts by setting up payment plans and explaining what their insurance covers and what it does not
  • Educate new patients about the practice's financial policies and their responsibilities
  • Accept credit and debit cards for payment
  • Educate employees on collection techniques so they understand the most effective methods of obtaining payment, such as not arguing with a patient, not becoming emotional and sounding confident
  • Implement a collection process that includes steps based on the time and overdue amounts
  • Visit for online tools to help you collect and manage your accounts receivable

Self-pay patients are an exception to many of these tips because they don't go through the insurance billing process. Some practices offer a discount for patients who pay in full with cash saving the group time and money because they don't have to send statements. However, check the language in your payer contracts – you can't charge self-pay patients less than you would charge patients covered by Medicare or commercial payers. If you go this route, develop a written policy for these discounts.

If patients absolutely cannot pay at the time of service, send them home with a payment envelope and let them know they'll see statements, messages and/or calls prompting them to pay.

Have you implemented any of these ideas in your medical practice? Did we miss any? Share your tips in the comments.

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Debbie - 5/1/2014 12:32:55 PM
I am in the process of interviewing applicants for front desk/receptionist and would like to know what questions would help me determine if the candidate can ask for payment/money at time of service?