It all starts at the beginning!
When 20% of the services of a typical medical practice are considered self-pay and should be collected at the time of service, why do you have so much debt? It just doesn’t make sense… It’s often difficult for your front desk team members to know how much to collect. There’s a difference in copayments and coinsurance, as we have discussed before. When you’re looking at your cash flow this is often the one area where you can make a quick impact. However, be careful you don’t scare away or alienate your patients by being too aggressive. Here are some steps you can take that will improve your point of service collections process so you can reduce back-end collections expenses and overall bad debt!
There are several things a front desk team member must do. They intake patients, meet/greet visitors, answer the phone, guard the providers from the various drug and equipment reps, etc. etc. In many cases, this position is often transient and when someone gives a notice of their intent to leave, it’s hardly enough time to begin the interview process for a replacement, let alone make a good decision on who you’re hiring. By the time a new person is hired, the organization is hardly in the position to give them proper training.
Don’t make this mistake! Often, the reason a front desk team member leaves is because they have not been properly trained and are frustrated with their role.  To alleviate this stress, make sure you have developed a strong front end training program that includes both written reference material as well as hands-on training.
- Front desk team members need to be trained in how to read an insurance card.  It may sound obvious, but it should be read from left to right and top to bottom. Why? Well, you may not know this, but there is a universal guideline that payors follow that requires they put any type of discounted plans they access on the top left-hand portion of the card. This information will help the front desk team member estimate the patient’s out of pocket portion.
- Have a clearly defined collections policy in place. Include items such as “what to collect at check-in†and “the additional fees at check-out.†Additionally, you should define your check acceptance policy, NSF fees, credit cards accepted, same day refunds via credit cards, expectations for self-pay patients and any discounts they are eligible for, insurance patients who do not want to use their insurance and the billing process associated with these situations, employee and provider family/friend discounts, etc.  All of these scenarios are important for the front desk team members to ensure they have clear directives to empower them to do their job with confidence.
- Teach them how to ask for money. I’ve witnessed many team members make the statement, “I don’t know why. I was just told this is what I have to do.† There’s nothing more disappointing than hearing this. That statement completely discredits not only his/her knowledge but minimizes the entire organization’s collection process if you think about it. Get your team members comfortable with explaining why they are asking for X amount of money and how they understand how difficult it is to understand the various guidelines from payors these days.  Make sure they have the appropriate amount of empathy necessary to complete the task. Mockup a couple of example superbills and have them role play with you or another team member until you are comfortable they can do it.
- Make sure your front desk workers are good typists! They will be the ones who start the overall billing process. Make sure they don’t input the wrong information, such as the insurance IDs, guarantor information, insurance plan, and billing information as well as patient demographic items used to properly identify the patient. Use a free typing test you can find online. It doesn’t hurt to have them do a reading and comprehension test while you’re at it.
- Do they understand the different payors? If not, you will need to explain it to them. Every patient with insurance will have a question about their plan. Your front desk staff are seen as experts by the patient and their family members. If they don’t know the difference in a Medicare and a Medicare replacement plan, then this could be a problem.
- Give them an updated price sheet. Make sure they know how much they should collect from the patients for all the services you provide, not just your top 50. Again, this empowers them.
- Educate your patients on your organization’s collection process. Make sure you have clearly communicated your collections policy to the patients both verbally and in writing. Post this on your website, at your check-in desk, and include it as part of your registration documents. This is a key step that many organizations neglect as they don’t feel it is necessary or think it is in poor taste. However, writing off accounts to bad debt tastes worse in my opinion.
These are just a few tips you can use to improve your point of service collections. If you have any questions, and/or would like for us to help design a strong point of service collections program customized to your organization, feel free to us [HERE].