Brinson advises otolaryngology practices to deploy a multi-pronged collections strategy that actually starts well before the patient walks into the office. The single most important step in that process, she said, is pre-registering the patient, by phone or computer, when he or she makes an appointment.
Explore this issue:February 2013
“You should be obtaining all of the patient’s information, including their insurance details, ahead of time,” said Brinson. “That includes the payer as well as the actual policy number. It seems like a no-brainer, but tons of practices don’t do this. Some say that their front desk staff would be on the phone with patients forever. But that’s not the case, and practices that wait for a patient to complete their information and input it only after patients check in are behind the eight ball. If there are mistakes or problems, then they don’t catch them until the back end, and that’s where we see problems with accounts receivable.”
If you anticipate that there will be some need to bill the patient on the back end—for example, a surgery for which the patient may not have full coverage—Brinson advises obtaining credit card information ahead of time. “Have them sign a statement that you will charge their card for any deductibles and coinsurance due after the claim adjudicates,” she said.
There are several technology solutions that can facilitate this process, including the Availity/RealMed health information network, which provides office administration and cash flow management tools, including point-of-service payment processing.
Gavin Setzen, MD, a partner in New York-based Albany ENT and Allergy Services, a seven-physician, four-physician assistant practice, said that a front-end strategy has significant benefits for the practice’s cash flow. “It’s very rare that we have to go to collections. If we have a high outstanding balance and it’s not a known hardship scenario, we might consider that, but that’s a very, very small number of cases.”
In most circumstances, he said, educating patients about what they might expect for a new-patient consult, including additional procedures that might be necessary, helps up-front collections run smoothly. “We give patients the option to talk to one of our billing managers before their visit, at check-in, or at any other time,” said Dr. Setzen. “It’s very clear in our paperwork and in our discussions with patients what their financial obligations will be.”
In today’s economy, more patients are asking for extended payment terms, according to Todd Blum, CEO of Ear, Nose and Throat Associates of South Florida, based in Boca Raton. “We’re sympathetic to the needs of our patients who are struggling, and we work with them as best we can, but we have our own expenses to cover.” In other situations, insurance company payments are retroactively taken back from the practice, leaving patients with unexpected balances, he added. Depending on the amount of money owed, his practice—on a case-by-case basis—will allow patients to spread out payments over several months, but not for longer than a six-month period.