Improve Collection Processes to Boost Private Practice Revenue

Could your private practice benefit from having another $50 a day? How about $100 a day? In a typical work year of 250 days, that would be about $25,000. And what if there could be even more money?

Seems like a silly question, doesn’t it? What independent practice couldn’t use more money, especially in the face of increased competition and several years of COVID-related income reductions? But, day after day, month after month, private practices across the country are shorting themselves of money due by not implementing an all-out attack on improving their collection practices. In fact, there are some very negative statistics about this stunning oversight:

  • In 2015, 68 percent of patients failed to fully pay off their medical bill balances. This number was expected to climb to 95 percent by 2020.
  • It takes over a month for 74 percent of healthcare providers to collect money from patients. Manual processes and a lack of alignment with consumer expectations may be creating patient collections delays.
  • 78 percent of providers cannot collect a $1,000+ patient balance in 30 days.
  • In 2010, patient copays made up roughly 20 percent of a doctor’s revenue, but a study by the Medical Group Management Association found that most physicians only collected 60 percent of their patient copays. This could be even more problematic as co-pays increase.

In an age where patients have suddenly expanded their payment preferences, most providers have simply failed to keep up. In fact, just 23 percent of providers offer eStatements, yet only 58 percent send less than half of those eStatements electronically. This article focuses on what your private practice can do to improve collection practices and boost the bottom line.

Tips for Boosting Patient Collections at Your Independent Practice

In September 2020, an article in Medical Economics acknowledged that collecting copayments and coinsurance had become increasingly difficult during the COVID-19 pandemic. It urged, however, that practices use the same creativity they had relied on to ensure safe patient access to the collections process. Recommended keys to a successful collections strategy include:

Improve Insurance Validation

Your private practice needs to step up its efforts to collect and verify all patient insurance and contact information before appointments. This helps to determine co-pay levels and assess patient financial responsibility. This must be done for every appointment, whether it is made in-person, on the phone, or online. If any outstanding balances are due, they can be addressed before the time of the appointment. You can integrate an insurance eligibility service into your practice management and EHR systems that allows you to run a verification check on every patient scheduled for a visit, so you can reach out in advance to patients for new insurance information, if needed.

Increase Education About the Cost of Virtual Services

One excellent way to expand capabilities without increasing facilities is through the increased use of virtual services, but some patients might not realize that there is a cost involved. Since the same amount of provider time is involved with an in-person or telehealth appointment, the cost should be the same. Yet many patients don’t realize their financial responsibility for a telehealth visit. This can be explained on the website, patient portal, and at the time the appointment is set.

Consider Upfront Collections

It is exceedingly difficult to collect money after a patient visit. In light of the need to sustain current patient volumes, some practices might forego this effort entirely, at their own financial loss. Instead, it is better to be upfront about patient financial obligations and collect initial payments prior to the service being provided wherever possible. If the level of care required changes during the appointment, the additional amount due can be collected in person or via other means after the service is provided, but at least you will have a partial payment.

Simplify Billing Statements

A chronic care patient with multiple doctors can receive an extraordinary amount of billing information from payers and providers. Make sure your bills are clearly marked as bills, and they show exactly how much the patient’s responsibility is. Designate a staff member to handle any incoming calls about bills that are received.

Upgrade Your Payment Capabilities

While some patients still appreciate the old system of paper bills and checks, the vast majority of your patients have moved on to electronic payments. Make it easy for patients to pay outstanding balances online or through the Patient Portal. Mobile payment methods should also be investigated for younger patients who like to use their smartphones to manage all their payment needs.

Utilize Electronic Billing Reminders

Old collections methods might have involved printing and mailing (hopefully to the right address) a stack of account aging notices. These could be delayed in delivery, easily ignored by the recipient, or rendered useless by a simultaneous payment. New billing reminders include text messages, email communications, and patient portal notices that can be easily accessed when the patient is online. Allow patients to click through to a secure payment site, so they can take care of the balance while it is still top-of-mind. Be mindful of legal collection communication tactics in your state when instituting new methods.

Payment Plans Produce Results

Some patients might be surprised at the size of their bill, with some of the plans available through the healthcare insurance market. If it becomes a matter of foregoing visits due to cost, your practice might consider a payment plan for long-term patients whose care needs have become more complicated.

Friendly but Firm in Collection Calls

If you think it is difficult collecting from insurance companies, some patients act like the Artful Dodger about their medical bills! If other outreach efforts fail to generate results, it might be necessary to have your staff make outbound telephone calls, or to outsource this process. This can be tricky because you don’t want to lose the patient, unless the lack of payment is egregious, and the calls need to be made with sensitivity to the patient’s condition. An outside service can handle this, or you can train internal staff to make these calls. Always make sure you are speaking directly to the patient or a designated representative before discussing finances. Have script prompts available to help deal with the various situations that might present themselves during the call.

Train Office Staff in Collections Awareness

Some team members might not be comfortable discussing the reality of money in a medical environment, but it is important for everybody to be onboard with this process. Provide consistent training for your team on how to communicate effectively at all patient touch points, to increase collections effectiveness, while still maintaining positive patient relationships.

Collection Mistakes to Avoid at Your Private Practice

Billing 101 may never have been a topic at medical school, but it is a key concept to master for the very survival of your independent practice. Key mistakes to avoid include:

Poor Collections Management at Time of Service

Many professionals ask for substantial payment upfront, but medical providers seem to have difficulty doing this. Recognize that you provide a vital service and deserve to be compensated for it. Avoid poor collections management by being clear about your payment policies, verifying insurance information, and being upfront about the money owed. Patients who are uncomfortable with this process might be the ones who end up being most difficult to collect from in the long run.

Being Lax on Denied Claims

A Medical Billing Service can help to reduce claims denials substantially. If you process claims internally, however, you still have a right to fight for your money, even though an insurance payer might initially deny a claim. Assess why the claim was denied in the first place. If you are not checking insurance eligibility upfront, you will have to correct that practice. If your billing and coding efforts are weak, you risk having more claims denied or rejected. When these steps are properly followed on your end, your office still needs to address the denial with the payer, and then correct and resubmit the claim when possible.

Minimizing Payment Options

Don’t miss out on any opportunity to make it easier for patients to pay. Even if it costs money to implement a payment option, think of how much that is saving in staff time, administrative resources, and non-payments. Accept payment at the time of service via credit, debit or mobile, and include the ability to pay online as part of your patient portal.

Ignoring Monthly Aging Reports

It is important to understand exactly how much money is outstanding and implement efforts to collect the oldest balances due. Try to hit the industry standard for a payment turnaround time of under 30 days. Achieving this goal requires clean claims, no billing errors, and prompt billing submissions.

Don’t fall victim to these mistakes; be diligent in your collections efforts. Talking to patients about their financial responsibilities can be challenging for you and staff members at your independent practice. During difficult conversations with patients about past-due balances, the American Medical Association suggests that it may be helpful to keep the following points in mind:

  • You provided a valuable service for your patient, and you deserve to be paid in a timely manner.
  • Your practice has made several efforts to explain your payment policies, work with payers, and notify the patient of their responsibility.
  • The patient has had several opportunities to pay – at the time of service, upon receipt of the EOB from the health plan, first statement, second statement, phone calls, and through payment options.
  • Patients know you need to ask for payment, but still want to be treated kindly.
  • Most want to continue receiving treatment from you.

Amazing Charts Provides Boost for Improving Collection Practices

Amazing Charts offers many solutions specifically designed to help your private practice survive and thrive. Our Medical Billing Service is a fully integrated Revenue Cycle Management service that handles the hassle of billing for you, and at a more affordable rate than most third-party billers. Your practice could experience an increase in collections, a higher rate of claims paid on first submission, and a quicker time to payment with your payers and patients:

  • Up to a 20 percent increase in collections
  • 95 percent of claims are paid on 1st submission
  • Quicker time to payment
  • Uninterrupted cash flow

CareTracker Practice Management from Amazing Charts lets you quickly identify coding inconsistencies prior to claims submission, electronically confirm eligibility and claim status, and easily identify unpaid claims. This usable and affordable practice management system will help your independent practice manage patient records, insurance eligibility, documents, and billing. Take control of your finances today with features that include:

Unpaid Claims

View unpaid claims, ensure they are worked promptly, and resolve issues before they become problems.

Claims Manager

Review claims before submission to reduce denials and maximize revenue potential.

Integrated Clearinghouse

A Secure Connect Clearinghouse that provides a high-level of support and responds quickly to payer changes.

Intelligent Dashboards

Intelligent technology provides interactive, role-based dashboards that automatically prioritize work lists for all areas of your office.

Reporting

Get a quick, high level view of your practice finances and identify issues you can resolve to avoid reimbursement delays.

U.S.-Based Support

Access a U.S.-based support team (via phone, email, or chat), who can utilize remote access to identify and resolve issues quickly.

Claims Status

Automatically check claims status for improvement in reimbursements.

Patient Payments

Let patients pay outstanding balances online with Quick Pay.

Payment Posting

Posting insurance payments is simplified and streamlined, saving time and effort.

Healthcare Technology Solutions Designed By and For Independent Practices

Amazing Charts was founded in 2001 by a practicing family physician to help medical practices thrive. We have grown consistently since then by creating easy-to-use solutions for delivering patient care. Today, we offer a variety of additional capabilities designed to help independent practices succeed, including Electronic Health Records, Practice Management, Billing Services, Population Health and Remote Care. Call 866-382-5932 to learn about our products, schedule a practice consultation, and learn more about telehealth pandemic lessons that can help your independent practice grow.