COLLECTING ACCOUNTS RECEIVABLESUCCESSFULLY

Prepared for the

Southern PiedmontPartnership forPublic HealthIncubator ProjectFinance Focus Group

by Kathy Hartsell

TO BE SUCCESSFUL IN COLLECTING

The process starts before the patient even comes in the door.

EXPECTATIONS

Where do we get our expectations? From our eligibility, debt management, fee, bad debt write off and any financial policy information forms that our patients sign.

Be sure patient knows what our expectations are when appointment is made and at time of eligibility.

HOW TO GREET A PATIENT

When a patient presents at the front desk greet patients warmly.

Always acknowledge the patient.

THE INTRODUCTION

Good morning. My name is Melissa, welcome to the Cabarrus Health Alliance, I will be checking you in today.

MAKE YOUR PATIENT FEEL COMFORTABLE

They may be apprehensive about being here.

PRINCIPLES OF COLLECTION

MANAGEMENT

COLLECT MONEY

BE:Professional

Pleasant

Persistent

THE THREE V’S OF COMMUNICATION

Verbal – 7% - What you say

Vocal – 37% - How we use our voice

Visual – 56% - What people see when we speak words

COMMUNICATION IS IMPORTANT

Tone of voice should be friendly.Do not sound cold or abrupt.Must be knowledgeable about your agency.Must have enthusiasm.

ALWAYS SMILE

Whether you are on the phone or in person, smiling has a positive effect on collecting money.

EYE-CONTACT

When face-to-face, the look in your eyes while collecting should reveal that you genuinely expect that he/she should pay for the service that was provided.

BE PROFESSIONALBe courteous even when a patient gets

nasty.Being too aggressive can hurt your

collection efforts.

BE A GOOD LISTENER

Always keep in mind that people are often dealing with health issues and other problems.

Express compassion for someone’s situation.Never assume a patient is intentionally not

paying until you have taken the time to listen.

COMMON PROBLEMS THAT CAUSE REVENUE LOSSES

Failure to collect patient’s previous balances.

Not obtaining current patient information.

Lack of, or inconsistencies in collecting copays.

ELIGIBILITY

Must be done correctly to achieve appropriate sliding scale.

INSURANCE

Must be verified before patient is seen.Be sure to make a copy of the card front

and back.Complete the insurance verification form.Always verify who the insurance benefits

will go to.Document insurance info in the PMS.

BE SURE TO COLLECT THOSE COPAYMENTS

The cost of sending out statements for copays is expensive and seldom results in collection. Small amounts due are often ignored by the patient. They assume the amount is an error or does not want to be bothered to write a check, mail or use a stamp for such a small balance.

Practices that do not collect copays are violating their contracts with payers who require them.

MEDICAID

At each visit check the Medicaid card for:

Eligible dates

Managed care information

Insurance information

Change in recipient’s name

Month card was issued

WHAT IF THEY FAIL TO BRING THEIR CARD

Enforce the need for patients to bring their cards when they come in for services.

Verify SIPS

WHAT IF YOU CAN’T VERIFY MEDICAID INFORMATION

Have patient bring in letter they received form DSS confirming they are Medicaid eligible.

If you can not verify Medicaid eligibility, then offer sliding scale fee. If no proof of income patient will be placed at 100% until verified, except for programs or if your policies that state you will accept declaration of income.

ASKING PATIENTS FOR

MONEY

HOW DO YOU ASK FOR MONEY

When a patient checks out, tell them amount owed and ask if they want to pay by cash, check or credit card, then wait for them to reply.

Do not say another word!The collector’s adage:

The next person who speaks, loses!

So let them speak next.

“I’VE NEVER HAD TO PAY AT THE TIME OF SERVICE BEFORE. WHAT DO YOU MEAN I HAVE TO PAY TODAY?”

What would you say in response?

“I CAN’T PAY IN FULL” OR “I DON’T HAVE THE MONEY”

“Our program services are based on a sliding scale fee to reduce your fee based on your eligibility and this is what you are expected to pay” Review eligibility with them.

“We do accept credit card payments”.

Negotiate with them “If you pay half today, we’ll send a bill for the balance due in 30 days.”

“SEND BILL NO MONEY TODAY”

Were you not told you would be expected to pay today? If they reply “no”. Apologize and give them our expectations.

If you can not get money, get a commitment from patient and follow-up.

Make notation in your patient management system of this excuse.

SYSTEMATIC FOLLOW-UPExample: “I will mail a check in two days.”Your response should be to:

Call them if you don’t receive a check. If you don’t, you lose credibility. Remember, you are in competition with other

creditors!

DISCUSSING THE ACCOUNTGet people to talk by asking questions.Don’t ask closed in questions that only

require a yes or no answer.Ask open end questions where they will have

to talk.

“HAVE A LOT OF BILLS TO PAY. JUST HAD A BABY AND HAVE A LOT OF HOSPITAL BILLS”

I understand you have a lot of bills to pay but ours is just as important as any of bills you may have.

You are expected to pay on this bill.

(This is where you use your negotiation skills) How much can you pay us?

WHAT IS A NEGOTIATION

Something you are willing to give up to gain.

CREATIVE THINKING IS NEGOTIATION

Understand the goals of the other person.Determine your own goals.Establish a range between your goals and the other

persons goals. Identify what goals can be left unmet.Think of alternate ways of collecting the debt.Help clients realize that the debts must be paid and

you are willing to work with their problems.Look at the issue from their point of view.

HOW DO YOU RESPOND?If someone tells you they are short on cash, ask how much are you short.

Persuade patients to pay with a credit card.

Get them to commit a date to pay amount owed.

Try not to go beyond 30 days.

Document and follow-up.

RESPONSES

If they ask “How much do I have to pay?”Start high instead of low. Be a negotiator.

Ask for $40 instead or $5 or $10.If they say they can’t pay $40, ask for $30.

PARAPHRASING

Take what the other person is saying and give back to them.

“I don’t have money to pay.” “I understand you said you don’t have money to pay but there is a charge on our service.”

“I have too many bills to pay.” “I understand about your bills but we do expect payment for our services.”

WHEN THE PATIENT LEAVES WITHOUT PAYING…

Collection is expensive!! Avg processing cost for self payers = $8 In 3 months time, $24 on one person is spent. Average cost of 800 bills per month

• $6,400 per month.

• 3 months time = $19,200

About 20% of what practices collect is spent on going after receivables.

Once they have left the office, chances of getting paid by self-payers could be cut in half.

After the 60-day mark the chances drop drastically.

CHANCES OF COLLECTING FROM THE CREDIT RESEARCH BUREAU

1 – 60 days past due: 90%

61 – 90 days past due: 50%

91 – 180 days past due: 20% (1 in 5)

NO FORWARDING ADDRESS

Currently, over $60,000 of debt is in accounts receivables.

Update address.

ADDRESSING OLD BALANCES

Patient may have and old balance but does not want to pay because they are now 0%.

Inform patient of old balance and state that balance should have been paid during that time frame. It was determined that you could pay during that time and you do owe that balance.

Start negotiations.

EXCUSES

Determine if it is an excuse or reality.Eliminate the excuse so you never have to

hear it again.Think ahead to the next excuse you might

hear and eliminate it now.Create a sense of urgency about getting

your bill paid.

EXCUSE OR REALITY?

I don’t have money to pay.

Ask why they don’t have money to pay.

Make monthly payment schedule until things pick up.

Sound as if your doing them a favor.

GET CLOSURE

Seal the deal.

Need a commitment for the agreement.

WHAT DO YOU DO WITH AN IRATE CLIENT?

Patients sometimes get mad with you because they owe you money and want to get out of paying their bill.

Remember you are a professional. Stay in control.

COOLING TIPS FOR THE IRATE

Actually lower your voice and speak slowly.

Stay personal and use their name.

Don’t get angry and avoid humor.

Passing client on to colleague often changes their tone.

Document

Document, Document, Document!Always note when you have talked with a

patient regarding their account. Good record keeping is a must because you may need to review payment history and excuses they have given you in the past.

THINGS YOU CAN DO TO MAKE BILLS STAND OUT

Stickers on bills (Insurance obligation and patient obligation).

Colored statements.Yellow highlights on statements.

HAVE GOOD REVENUE CYCLE MANAGEMENT

Measure performance on:

Collections

Claim submissions

Denials

FAIR DEBT COLLECTION PRACTICES ACT

This act requires that debt collectors treat you fairly and prohibits certain methods of debt collection. Of course, the law does not erase any legitimate debt you owe.

HOW MAY A DEBT COLLECTOR CONTACT YOU?

A collector may contact you in person, by mail, telephone, telegram, or fax. However, a debt collector may not contact you at inconvenient times or places, such as before 8 a.m. or after 9 p.m., unless you agree. A debt collector also may not contact you at work if the collector knows that your employer disapproves of such contact.

CAN YOU STOP A DEBT COLLECTOR FROM CONTACTING YOU?

You can stop a debt collector from contacting you by writing a letter to the collector telling them to stop. Once the collector receives your letter, they may not contact you again except to say there will be no further contact or to notify you that the debt collector intends to take some specific action. Please note, however, that sending such a letter to a collector does not make the debt go away if you actually owe it. You could still be sued by the debt collector or your original creditor.

MAY A DEBT COLLECTOR CONTACT ANYONE ELSE ABOUT YOUR DEBT?

If you have an attorney, the debt collector must contact the attorney, rather than you. If you do not have an attorney, a collector may contact other people, but only to find out where you live, what your phone number is, and where you work. Collectors usually are prohibited from contacting such third parties more than once. In most cases, the collector may not tell anyone other than you and your attorney that you owe money.

WHAT TYPES OF DEBT COLLECTION PRACTICES ARE PROHIBITED?

Harassment. Debt collectors may not harass, oppress, or abuse you or any third parties they contact.

Use threats of violence or harm.

Publish a list of consumers who refuse to pay their debts (except a credit bureau).

Use obscene or profane language, or repeatedly, use the telephone to annoy someone.

UNFAIR PRACTICES

Collect any amount greater than your debt, unless your state law permits such a charge.

Deposit a post-dated check prematurely.

Use deception to make you accept collect calls or pay for telegrams.

Take or threaten to take your property unless this can be done legally.

Contact you by postcard.

REMEMBER

Salary adjustments are based on the year end results so how well we collect does have an impact on ourselves and everyone we work with.

Information SourcesCollecting Accounts Receivable, presented by

National Seminars group a division of Rockhurst University Continuing Education Center, Inc.

U. S. Department of CommerceCredit Research BureauPhysicians Practice March/April 2002 issueFair debt collection.comFocusing on Front Desk Collections: Balancing

Effectiveness with Compassion Webcast – Health Resources and Services Administration