MGMA In Practice blog

The most frequently asked question that Elizabeth Woodcock, MBA, FACMPE, CPC, gets from medical practice administrators is, "How can I get more money in the door?" It's the same question we recently asked the professional speaker, trainer and author specializing in medical practice management.

The environment you're dealing with in your practices isn't easy. The recession caused an increase in uninsured patients. Uninsured patients caused an increase in bad debt for practices. And insured patients are actually assuming higher financial responsibility, based on their employers' plans. Faced with all these pressures, how do you amp up your patient collections efforts?

Woodcock shared her 3-tiered strategy with us in an MGMA podcast, and we've transcribed part of it here:

This step sets up all the collection efforts to follow. Take a look at your contracts and participation agreements with insurance companies and see what you're allowed to do. For example, can you collect copayments or unmet deductibles?

Also, keep in mind whom you'll be collecting from. Woodcock says there are three types of patients: 

1. The happy patients who have their credit card ready and waiting
2. Those who need a little nudging, or maybe a compliment or two
3. Those who have no intention whatsoever of paying you

Expect your collection agency to step in and assist with the second group of patients - the nudgers.

This step combines pre-visit, time-of-service and post-visit communications. One of Woodcock's favorite time-of-service collection tips is the collection script. Instead of asking the patient if she would like to pay today, which can prompt someone to say no, ask her how she would like to pay. Changing one simple word can make a world of difference in the staff-patient interaction.

Woodcock also recommends offering a payment plan for a patient who simply cannot pay right now. "It's a great alternative to getting nothing," she says. But put parameters in place: don't extend the plan past six months and have a minimum monthly payment of $25 dollars. Ask the patient about their time frame; in general it will be a tighter time frame than you would have developed yourself.

Another step to remember is patient check-out. "Check-out is an opportunity to be a safety net for your collections process at the time of service," says Woodcock. It also offers an opportunity to recapture copayments you may not have collected at check-in. Plus, you can see if any account balances are due and possibly calculate any unmet deductibles or coinsurance based on the services rendered in the office that day.

See these 40 questions to ask yourself about patient collections to ensure you're doing all you can.

Should you hire more people? Have a financial counselor? Could a kiosk or predictive dialer employed in the business office help? How you implement your plan depends on what's best for your practice and staff.

Woodcock describes how one practice decided to use the patients' explanation of benefits (EOB) to help them collect unmet deductibles and account balances. The front office initiated the payment conversation, and when a patient would make an excuse about paying, the staff handed them the printed EOB and explained how the insurance company already took care of a portion of their bill. Staff invited the patient to call the insurance company if they had any questions, then asked again for payment.

"It is a wonderful best practice and a great success because it really allows the practice to be put in an advocacy position instead of the bad guy," says Woodcock. "Truly, a medical practice administrator and all of the front office and business office team members really are advocates for the patient. And unfortunately, they've been put into the 'bad guy' position. This was a way to turn that around and be successful in collecting as well."

For more patient collection tips from Woodcock, check out her book, The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid, 2nd Edition, or meet her in person at the following upcoming MGMA specialty conferences:

• MGMA 2010 Academic Practice Management Conference
• MGMA 2010 Financial Management and Payer Contracting Conference
• MGMA 2010 Obstetrics and Gynecology Practice Management Conference