Your practice may be limited on the number of staff employed which means you or a CA is fulfilling the role and function of office manager or insurance biller. No matter who assumes these responsibilities, it is imperative that critical financial information is gathered and fees are collected.
by Dan Zimmerman in Payments and Collections on Thursday, December 15, 2016
As the practice expands, a start-up doctor can "grow" his/her staff into other roles with the assurance that collections will always be handled if each role and function has been defined and a process established.
Here are the some key points for collecting patient fees:
- Understand each staff member's role in the financial process and define it in his or her job description.
- Verify insurance information to determine eligibility. Be sure you have complete identification numbers, date of birth, social security number and a copy of the patient's insurance card.
- Collect co-pays, co-insurance and deductibles when service is rendered.
- Understand the process for pre-certification. This can vary with each insurance company.
- Watch for correct coding on claims. Clean claims process faster, assuring good patient service.
- Determine if your accounting system will tie into your patient billing process
Establish a Fee Schedule and Payment Policy
A fee schedule and payment policy must be established for the practice. For example, what portion of the practice income will be indemnity, co-payments, deductibles, or cash? The schedule and written policy must accommodate fees that are reasonable and customary and reimbursable under indemnity plans, HMOs, PPO's, etc.
Make Sure the Patient Understands!
Additionally, it's important to have a payment policy so patients know when payment is due for services. Fees must be enforced and collected. This way, patients will understand that they are receiving value. No one likes to ask for money, but money must be collected for services if the practice is to succeed.
If the patient understands the payment policy up front, the room for hurt feelings is minimized. There is some anecdotal evidence of a correlation between a patient suing a doctor for malpractice because they feel they are being pressured for collection. There are also legal ramifications regarding professional discounts in different government regulations and also the effort that must be made to collect amounts due from patients to avoid a perception of discounting or rebating fees.