Your Front Desk, Your Front Line Collecting From Patients at Time of Service

By Robert B. Charlton, CPA/ABV, CVA and Deirdre Hartmann, CPA

March 2010

What is your front desk doing to ensure your patient accounts receivables are under control? More crucial, what isn't being done can be detrimental. Taking steps now to collect every dollar earned will benefit your practice by not allowing your profits to slip through the cracks. As the trend moves towards shifting more risk to the patient, honing your patient collection skills becomes imperative. Each practice should track their insurance receivables and the guarantor (patient) receivables. Studies show that collecting from patients at the time of the encounter maximizes your collection percentage and decreases collection costs. This article focuses on strategies that should be implemented to collect at time of service and is geared towards helping your front desk staff achieve winning performance.

Attitude is Everything

Your front desk staff is a patient's first impression of your practice. They should be greeting your patients upon arrival. Your staff should present a professional attitude and appearance, be polite, and possess strong customer service and communication skills. They must feel comfortable explaining the patient's financial responsibility and indicating that payment is expected at the time of service. Their attitude needs to be friendly, yet firm. The physicians in the practice need to be supportive of the collection policy and refer any discussions regarding financial matters to the appropriate personnel, rather than discussing with the patient. Your office should have a clear, written financial policy, which should specifically state when you expect payment. This will empower your front desk staff and send a clear message to patients.

Training's a Necessity, not a Luxury

Front desk personnel should receive training so they are prepared for situations that arise when attempting to collect from patients. We recommend writing scripts for the most common scenarios that front desk personnel encounter. Starting from the time the appointment is scheduled; the patient should be informed that payment is expected at time of service. Those patients with outstanding balances should be asked to clear their balance during the visit. Having a script reduces guesswork for the staff, and establishes common procedures that should be followed consistently. An example of a script for this situation would be "Both your payment (or copayment) for this visit and your prior balance of $XX will be due at the time of service."

Accountability is Key

After providing training to your front desk staff, each individual's performance should be measured. Collection goals should be established. We recommend tracking daily performance, seeing who is performing and who is not. For those who are not up to standard consider re-training. If after re-training, goals are continuing to fall short, it may be more beneficial to replace underperformers. Be sure your performance reviews are documented and are communicated to the underperforming employee. Also consider incentives for those that meet and exceed performance.

In Network or Out-of-Network

Does this scene sound familiar? A patient calls to schedule an appointment and is asked if the practice accepts their insurance. Does your employee say we are not in the plan and hang up? Or are they trained to inform the patient that your office accepts out of network benefits and explain the patient's responsibility. Many people want the best medical care available. If patients are informed properly, they may choose to see an out-of-network physician.

Knowing What to Expect

Early communication with patients in explaining their out-of pocket costs increases your collections and improves patient satisfaction. This speaks true for the relatively minimal co-pay in a primary care practice as well as a large patient responsibility for a surgical procedure. Knowing the financial expectations in advance decreases the patient's anxiety. There may be patients that do not have insurance or require some kind of financial assistance. It is beneficial for your front desk staff to counsel uninsured or underinsured patients which can include working out payments plans or informing them of financial programs available to them.

Using Technology Can Help

Using all the tools available to you can help increase collections. Just recently, Navinet, a health information exchange company, has collaborated with some of the largest insurance carriers in the State of New Jersey. This site can be used by practices to verify benefits in real time, submit claims, claim inquires and to obtain referrals and authorizations. Many practices have voiced positive feedback stating increased efficiencies and reduced administrative costs by utilizing this centralized insurance exchange.

It is important that you, the physician, are paid for the services you render. Implementing these steps in your practice will increase your collection performance and bolster your bottom line.

This article appeared in the March 2010 issue of New Jersey Physician magazine.