7 Strategies to Optimize Patient Responsibility Collections for Orthopedic Practices

Laura Dyrda -  
The recent trend toward high-deductible insurance plans has increased patient responsibility for medical billing, especially in high-cost, non-preventative scenarios like orthopedics. "A couple of years ago, the specialists saw 5-10 percent coming to them from patients directly," says Kevin Weinstein, vice president of marketing for ZirMed, a billing solutions, patient collection solutions and revenue cycle management company. "Now it might be 30 percent. The orthopedists need to have processes and tools in place to deal with the fact that 30 percent of the revenue is coming from all these different individuals instead of a small number of payors." Collection rate among individuals can be less than half of the rate expected from payors, which can pose a significant problem to the practice.

Mr. Weinstein discusses seven strategies to optimize patient responsibility collections.

1. Have an upfront written financial policy.
It's important for practices to have a written financial policy for collecting from their patients. Part of this policy should include securing authorization and payment information before the procedure, says Mr. Weinstein. "Give patients [an] estimation of how much will be charged to their account before authorization," says Mr. Weinstein. When you have prior authorization, you can bill immediately after the procedure instead of waiting for a paper copy to reach the patient, receive authorization and be sent back. "It takes the patient responsibility of accounts receivable down to zero."

2. Clearly communicate pre-visit eligibility and financial responsibility. Make sure a patient is eligible for coverage at least 24 hours before their visit. If physicians see an ineligible patient, they may not be able to recover payment for that visit. Practice staff should also contact eligible patients before the visit to make sure they remember their appointment and understand the payment policy. "You should clearly communicate how long the payment process will likely take," says Mr. Weinstein. "Set some expectations about what will happen. Based on the payor, give a final estimated amount on what the patient's level of responsibility will be over the next few weeks."

3. Collect co-pay before the visit.
Secure co-pay before the visit when patients are in the waiting room, says Mr. Weinstein, instead of waiting until after the visit. "Before the visit is when patients have the most time and the staff is less rushed," he says. You can also collect credit card information and authorization during the time before the visit. If you already have this information, make sure the patient is aware of and has signed any new policy statements.

4. Send several types of billing statements.
If the patients don't prepay for the visit, you will have to send them billing information. Send the patient's initial bill out the door as quickly as possible, and a second bill if payment isn't made promptly on the first. "Don't feel obligated to wait 30 days to send a second reminder," says Mr. Weinstein. The statements can be sent through paper mail or electronic delivery systems with an online component so the patients can go to the website and make payments with their credit card.

5. Use simple format on billing statements.
The simpler the statement looks, the faster and more complete your collection will be. "If you have a poorly designed statement, patients are likely to be confused and leave it for later," says Mr. Weinstein. "You should make sure the payment options are available on the statement, such as paying online or over the phone." You can also have patients mail in their checks, but don't have them mailed to the office. Take advantage of a financial services company to turn those payments around quickly.

6. Include a personal note with the bill. When patients receive a bill at home for their medical services, they don't always connect the physician with the bill. People often feel freer to ignore healthcare debt than credit card debt. Including a short cover note from the physician discussing the importance of timely bill pay can help collect quicker. "Have a cover note from the physician that follows up with the patient's condition and asking them to pay the enclosed bill on time," says Mr. Weinstein. "Tell the patient that you are able to provide good care because of their payments. Tell them the payments go toward things like the nurses' salaries or continuing education. This really makes a huge difference in how quickly someone pays."

7. Hire an empathetic person to collect medical debt. Medical debt collection is different than collecting on other types of debt and collectors should be trained in handling a potentially delicate situation. "It takes a special kind of person to go to people who are in a financial situation and approach them, when their single biggest concern is their health, and you are coming after them for rightfully earned dollars," says Mr. Weinstein. "A person just calling them isn't going to be effective."

Learn more about ZirMed.

Read other coverage on orthopedic practice management:

- 5 Ways to Maximize Your Orthopedic Practice Profits


- 5 Tips to Maximize ASC Collections


- 6 Techniques for Maximizing Revenue Cycles at Orthopedic Practices


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