How to tackle Rising Patient Balances

Patient outstanding balances are on the rise. Patient A/R is at it’s highest ever. I am not talking about self-pay patients. Sometimes self-pay patients can be good at paying.
One of the main reason why patients owe you money is because of healthcare plans in force.

There are two main reasons why this situation arises. Both have to do with insurance plans that may be provided by employers.

1. Increasing deductibles and
2. Increasing ‘per-visit’ co-pay amounts

You would think practices have a collection plan in place, but you will be surprised. I have seen established practices that just ‘wing’ it and leave it to the whims of staff and providers to tackle patient balance receivables. 

In a recent conversation with a provider whose patient A/R over 90 days was 46% of all outstanding, he was afraid of pursing ‘collections’ for the fear of losing patients.

It does not have to be an all or nothing approach. You need a well thought out and effective collections plan and process in place that involves your entire staff. 

Here are 5 effective steps you can consider.

1. At the time of scheduling appointments for patients on the phone, make it a practice to check that patient’s outstanding balance. Of course, this task becomes easy if your integrated EHR/Billing systems allows you to quickly look it up. If patients owe money, they should be politely reminded to pay at that time with credit card, or bring payment at the time of the visit.
2. When patients check-in, check for outstanding balances again, and try to collect past balances along with co-pay for that visit.
3. If available, take advantage of an automated system of sending patient statements. Good systems allow you to set up ‘rules’ for sending statements. For example, send statements to patients with a balance of $25 or more. Send statements on a monthly basis automatically and monitor how many statements have been sent.
4. If you have a very large over 90 day A/R, set up a plan including making phone calls to collect the money. This can be a short term focused campaign to bring down the aging.
5. Send patients to external collections. This is one of the toughest decisions for a provider. One reason why it is difficult because there is no plan and system in place. A well thought plan removes subjectivity. 

A good internal process coupled with an integrated EHR / Practice Management system can make it seamless to pursue patient collections and reduce A/R.