Getting Your Dues: Best Payment Practices

medical payments



Consumer Directed Health Plans (CDHPs) place the responsibility on patients to budget, and determine the what, where, and when of their healthcare. But with the number of CDHPs on the rise (a large number of employers are now switching over to the CDHP model), and the number of patients receiving healthcare services without having met their deductibles, more and more private practices are experiencing cash flow problems.

While we would like to believe that those we have been treating for quite some time will meet their obligations in a timely fashion (without consistent “friendly” reminders), the simple fact is that a majority of them wont, and this will undoubtedly put a strain on both your income, and patient-doctor relations unless you implement the necessary payment procedures.

Embracing the new paradigm

When we want something, be it a new cellular device, computer, television, or even a car, we are usually presented with a variety of ways of paying for it. This concept of putting some money down and paying off the rest over time nothing new. But the last several years have seen the growth of a more consumer-centric dynamic within our consumer culture. People want to know exactly what they are getting, what it will cost beforehand, and be allowed to pay for it in a way that is tailored to their needs and circumstances.

Now, you may be thinking, “I am a doctor, not a car salesman. I provide something crucial to the daily wellbeing of people everywhere. A need, not a want.” While this emphasis on need is correct, it is also correct to say that doctors provide services to their patients. As we covered in previous posts, some doctors provide ancillary services, and even sell certain products based on market factors like geography, and the average age of those they treat. In fact, given the ways in which a modern physician must market his/her practice (the subject of yet another recent post on this blog), we’d wager they have more in common with the car salesman or auto-mechanic than they think.

The bottom line, for better or worse, is that the consumer is in charge. A “retail” approach in healthcare is no longer just a possibility. It is now the reality for most practitioners. If your practice is struggling to adapt, the first thing to remember is that resistance to change will power you in no direction except backward. As for the second thing: remember bookstores, electronics chains, and other “brick-and-mortar” businesses? Many have been able to flourish in this new economy because they have implemented the same strategies we’ve highlighted here. This includes, but is not limited to, payment plans.

A variety of payment options

The simple fact is that most patients who do not make their payments on time cite the lack of payment options as the number one reason. If something, even a bill that must be paid no matter what, represents confusion, anxiety, or a very present financial burden, many people will simply choose to ignore it (think of a sitcom dad placing a strip of electrical tape over the CHECK ENGINE light on his dashboard). Being transparent about cost, and communicating in a forthcoming way at the point of service can assuage this. Moreover, so will offering a variety of convenient ways for patients to pay their bill.

Let’s begin with an old hobby-horse of this blog: technology. Many smartphones now have built-in payment capabilities. A good number of major retail chains have taken advantage of this technology, and so can your practice. A few posts ago, we extolled the benefits of the e-health model, and the importance of patient portals, those digital spots where patients can access both their treatment and billing history.

Allowing payments through mobile devices is just the beginning. Let’s backtrack a bit. Be sure to allow both debit and credit card payment, and, yes, checks. Remember to keep cards and other information on file. Be open to the idea of financing plans, or automated, recurring monthly payments. The latter is the preferred method for cellular and cable service providers, and it has worked well so far. Depending on the size of your practice, it might be a good idea to use a third-party vendor to automate the payment processing, store patient credit card data, and protect against any financial risk. Of course, do your homework beforehand. Whichever service you choose, it must meet “Payment Card Industry Data Security Standards” (PCI DSS).

The frontline of payment…

…is, and will always be the front desk. Your front-office staff should all have the verbal panache to broach the topic of payment with a patient. As we already stated, transparency is important. Offer patients written estimates which show what their insurance plan allows for procedures and services, with respect to coinsurance, copay, and unmet deductibles.

This element should be integrated into your daily office procedures. It would be worthwhile to draft a guide detailing all the protocols for dealing with insured vs. uninsured, in-network vs. out of network, contracted plan vs. Medicare, etc. Each set of circumstances presents a variety of payment options. Your staff should know all of them, or at least be in a position to draw readily upon a resource that tells them.

Remember tools, like cost-estimators. This nifty innovation allow instant access to rate, deductible, and coinsurance info. In the event that a cost estimator is not attached to a patient’s plan, there are third-party apps, including one for the iPhone, which do this math for you, provided the data is correct.

In a sense, you are turning your front desk into what is known in the retail world as a “point of sale”. Yes, you still run a medical office, and no, your attitude does not change. You are simply ensuring that you will be compensated for services rendered, all the while keeping in mind what is most convenient for your patients. They will thank you for it.


Brian Torchin

| HCRC Staffing | |

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