Seven Ways to Improve Your Patient Collections

Betsy Nicoletti, M.S., CPC September 10th, 2012

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Seven Ways to Improve Your Patient Collections

It’s not front-page news: patients have higher deductibles and out of pocket costs, shifting the burden in medical practices from insurance to patient due collections.

Medical practices have responded by routinely checking payer websites to discover if the patient has met their deductible.  Many insurance sites also present information about patient due amount for the benefit/service being provided.  Groups can do this in batches, for an entire day’s schedule or on demand for a last minute appointment.  Once the practice knows the patient due amount, here are some of the key elements to effective patient collections.  At the end of this article, there are links to other Kareo resources that discuss these six elements in more detail.

  • A written financial policy – This policy should be given to the patient and posted on the practice website.  This clearly sets expectations and gives the staff guidance in their activities.
  • Discussion with the patient about their financial obligation – Ask the patient for payment, and discuss large bills.
  • Consistent collection of co-pays and patient due amounts at the time of service – Most practices collect co-pays reliably, but it is also important to remind patients of past due balances and ask them to pay these while in the office.
  • Collecting surgery deposits prior to the procedure – When a patient has time to plan for surgery, the practice has time to collect for the surgery.  Use a claims estimator or call the insurance company to find out what the patient due balance will be.  Collect a deposit before surgery, and discuss how and when the balance will be paid.
  • Ability for patients to pay on-line through a secure portal – This is important for all practices and all patients, but keep in mind that some young patients may not have a checkbook.  They are accustomed to paying all their bills on line or with a debit card.
  • Collection efforts of past due amounts – Don’t let receivables age.  The older the debt to the practice, the less likely it is to be paid.  Follow your policy, attempt to collect and then send accounts to collections.

A seventh key element in a robust collection policy is:

  • Replacing budget plans with electronic recurrent payments.

Gyms do it.  Mortgage companies do it.  Places of worship do it.  These organizations don’t send a monthly invoice and hope to be paid on time, month after month.  They set up an automatic payment from a checking account, debit card or credit card.  This automates the process of monthly payments and is the up-to-date method to manage budget payments and “promises to pay.”

A surgical practice might use the process for a planned procedure. At the time of scheduling, the surgery scheduler would obtain an estimate from the insurance company showing the patient due amount.  After collecting the surgical deposit, the practice would arrange the remainder of the balance in three to six payments after the surgery.  Three payments would be ideal and would result in payment in full by the end of the post op period.

An OB group might arrange for seven recurring payments of the patient due amount to end coinciding with the due date.  When the baby is born, the bill is paid.

Any type of practice could use this to arrange payment for a patient who has run up a large bill.  Someone in the practice should talk to the patient at the time of a visit and set up a schedule using a recurring debit or credit card.

Emergency services in the hospital pose a particular challenge for practices.   The service is performed without any staff contact with the patient.  If the service is a surgical one, in a perfect world the patient will present to the office for at least one post op visit.  Use that visit to discuss the fee and set up those recurring, automatic payments.  If the patient doesn’t have a follow up service in the office, attempt to talk to the patient by phone to set this  up.

There are commercial vendors that provide easy interfaces and portals to do recurring payments.  Or, a group could talk to their own bank.  One method that is not recommended is to keep patient credit card information in a non-secure manner (file cabinet, excel file) and manually charge the patient each month.  Not only is it time consuming it may not be compliant with Payment Care Industry (PCI) rules.

“I’ll mail you $20 every time you send me an invoice” is an ineffective way to collect balances from patients.  Recurring payments are effective and efficient.

Expert Betsy_Nicoletti_advises how to improve your patient collectionsBetsy Nicoletti, M.S., CPC, is the founder of, a wiki for physician reimbursement. She is a nationally known speaker and consultant, and can be reached at She recently wrote for Getting Paid on Denials: A Removable Obstacle on the Road to Getting Paid.

Additional Resources

Register now for our upcoming webinar, Improving Your Bottom Line Through Patient Collections, featuring expert consultant Donna Weinstock.

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