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Streamlining your medical practice's patient collections goes beyond simply collecting from patients at the time of service. In fact, there are many ways to improve patient collections, from performing a monthly charge-capture audit to having your front desk adequately staffed. Are you as a practice administrator doing all you can to maximize revenue? Answer these questions, compiled with help from the MGMA Health Care Consulting Group, to find out.
1. When scheduling the patient's appointment, is staff mentioning the fees/copays required during the visit?
2. Do you offer flexible payments plans for patients who cannot pay in full?
3. Do you accept credit and debit cards?
4. Do you use kiosks in your practice?
5. Are signs about copays clearly displayed at the front desk?
6. Are employees consistently asking for copays?
7. Do you provide appointments for your patients when they want them? Deliver a valuable service, and it's easy to ask for payment.
8. Do you use your automated appointment reminder system to also remind patients of past-due balances and/or expected copays at the time of their appointments?
9. Does your checkout employee look up as soon as the patient arrives at the checkout station to greet them promptly and start the checkout process?
10. Do you have a countertop with a pen and calendar readily available so that the patient can easily write a check or set their things down while reaching for their wallet?
11. Does your cashier/checkout person say "thank you" when the patient makes a payment?
12. Do you have cash on hand to provide change to patients who pay using a large bill ($50 or $100)?
13. Do automated receipts print from your system to link the patient's payment to their account, assuring the patient that posting mistakes are eliminated?
14. Are you checking for patient insurance eligibility and benefits at least two days before a scheduled visit?
15. Does your practice have a clear written policy regarding patient financial responsibility (collecting copayments and prior balances)? If yes, is it followed?
16. What are your lag times? Identify the times between date of service and
a. Date of charge entry
b. Date of claim submission
17. Do you collect and monitor data regarding reasons for denials and use the results to train your employees?
18. Do you perform a monthly charge-capture audit to ensure that all types of charges and place-of-service information is accurate?
19. Does your practice base its fee schedule on a quantifiable process or is it determined in an indiscriminate manner?
20. Are you using all the services offered by your clearinghouse?
21. Does your business office share the reasons for electronic charge rejections so staff can be trained, or does the business office employee correct the errors himself because it's easier and faster?
22. Do you monitor both categories of write-offs: contractual and non-contractual?
23. How often is a credit balance report run?
24. Does your practice comply with state and federal laws regarding credit balances?
25. Do you prioritize your outstanding accounts receivable by balance due (high to low), account type, payer type, date claim submitted, date of service and age of account?
- Have you developed and do you follow a policy concerning patients that cannot pay co-pays on the day of service? Will you tell them they need to reschedule?
- Do you use a tiered approach to patient collections and match the collection effort not with the patient balance but with the expected payment?
- Do you use a monthly bonus system for employees who collect patient payments in the office?
- Have you implemented online billing and payment tools?
- Have you recently assessed your current billing statement effectiveness?
- Does your practice assign accounts receivable by alphabet or by payer type?
- Is your billing staff cross-trained so that when one person is out the entire process can continue seamlessly?
- Do you establish performance targets for the staff and trend them over time?
- Is patient collections performance benchmarked to practice results and to MGMA survey data?
- Is your practice maximizing features and capabilities of your practice management software?
- Does your practice have a super-user on site for the practice management software, or do you have to rely on tech support for every question needing an answer?
- Has the front desk staff been trained in the proper way to ask for payment?
- Is there adequate privacy at the front desk area so that staff may speak with patients regarding outstanding balances without everybody in the reception area hearing?
- For patients with outstanding balances greater than the acceptable age (60-90 days), do you ask the patient to sign an agreement for settling the previous balance and require either a deposit on the current visit or payment in full?
- Do you ask patients to sign a promissory note?
Sources
1-6 from MGMA resources
7-14 provided by Rosemarie Nelson, MS, MGMA principal consultant
14-25 provided by Cindy Dunn, RN, FACMPE, MGMA senior consultant
26-30 provided by John Emerson, MGMA consultant
31-38 provided by Ken Hertz, CMPE, MGMA principal consultant
38-40 provided by Trip Kinmon, FACMPE, MGMA consultant