As you analyze your current collections strategy, it’s critical to assess collection of patient balances after insurance has processed. Consumer-driven and high-deductible health plans has necessitated other time-of-service collections strategies. While collecting copays or other payment on accounts is critical. For example, if staff misses collecting two $50 copays per day, this adds up to $25,000 annually that will need to be collected through statements and calls.
Having a thorough process of patient statements, phone calls, collections letters and formal collections will ensure you gather the most patient dollars in the shortest period of time. Having the collections process driven by account audits and deadlines will ensure the focus is on non-paying accounts. Taking responsibility for patient responsibility means having each step documented, daily monitoring, as well as technology and staff training that gets results. 
ORI utilizes cycle billing that generates an even flow of statements every week which translates to an even flow of patient phone calls. All posting exceptions are reviewed and completed prior to the statements which helps avoid unanswered questions that carry over in the future months. Full color statements customized to the needs of the practice are created and include electronic payment links and the ability for patients to pay using all major credit cards as well as ACH check processing on-line. Statements are also available for viewing by customer service staff to help patients answer billing questions and walk through their balance owed.
Returned mail is a huge area for potential loss. ORI takes responsibility for patient responsibility by utilizing professional quality skip tracing tools and techniques to address return mail. First, at the clearinghouse all addresses are scanned and invalid address are added to a queue for review prior to the mail going out. Second, if mail is returned, each address and patient is scanned to acquire up-to-date billing information. The records are updated and a new statement is sent timely.
Some practices are utilizing optional e-mailed statements. Email statements are generated through the clearinghouse and require the user to sign-up for the service. Once enrolled, the patient will receive a secure e-mail and can log-in to view their statement past and present.
After two statements, ORI initiates a series of calling campaigns. Before each campaign all outstanding balances are audited and any patients who have not responded, or have not made a recent payment are contacted. After 10 days another statement is sent and then a second call is made to the patient. The combination of statements and calls generates a large volume of payments, however there are always patients that don’t respond.
Each step of the patient responsibility collections process is noted on the account to provide records for future scheduling or dispute resolution when patients insist they tried to pay their balance. A collections letter is sent which let’s the patients know that if no response is received within 10 days the account will be recommended for collections. For patients that call, the notes can be used to emphasize that time is up and the balance is past due.
This provides the opportunity to setup an approved payment plan which meets the practice guidelines. Any payment plan that does not meet the predetermined criteria is an “unapproved” plan and does not remove the patient from the collections process. A list of all unpaid accounts or those with unapproved payments plans is provided to the practice each month to approve for formal collections. Again, each account is audited to ensure the correct balance is being recommended.
The collections process does not stop at this point but continues with the collections agency in the drivers seat. ORI continues to support the collections effort by providing account ledgers to the agency and account documentation for issues like bankruptcy. The key is to stay out of the collection agencies way so they can professionally maximize recovery.
Having an end-to-end process ensures providers get paid for their efforts. For those patients that do not have the ability to pay a courtesy adjustment can always be made. However, when no documented process exists the courtesy adjustments and losses from an inconsistent and disorganized process may make providers feel like they are working for free. Don’t let this happen to your practice – give Outsource Receivables a call to have a collections process assessment as part of an overall practice analysis. Take responsibility for your patient responsibility and fill out our contact form and request a free assessment for your practice.