Collection Objection: Overcoming Patient Excuses for Why They Can’t Pay

If collecting patient payment at the point of service was important before, then it’s mission-critical now—especially as reimbursements continue to shrink. That’s because—as we’ve mentioned in this post, this post, and this post—only 21% of patient balances that aren’t collected at the point of service are ever recovered. That’s a lot of cash you’re leaving on the table if your patient collection strategy is not on point. So, in addition to implementing a solid payment policy, successful providers must also ensure they have an excellent front office staff with the qualities necessary to enforce that policy and overcome objections when patients can pay, but would rather not. According to Courtney Peterson—MultiCare Health System’s administrator of business operations—“If our front-end registrars do not know or can't speak with confidence about what they are attempting to collect, our patients will notice that." And that’s not good for anyone. With that in mind, here are several common patient objections—as well as ways you and your team can confidently overcome them (adapted from this National Center for Farmworker Health (NCFH) resource):

“I have insurance; it pays for everything.”

As WebPT President Heidi Jannenga and CEO Nancy Ham discussed in a recent webinar, many patients believe that because their insurance “covers” your services, they’re not responsible for paying anything out of pocket. And that’s rarely—if ever—the case. The best way to overcome this type of an objection is with education. Ideally, you’d have this conversation with the patient well before you attempt to collect payment. In fact, it’s best done immediately after verifying insurance information—before your patient comes in for his or her first appointment. That way, your patients will know in advance what they should expect to owe in terms of copays, coinsurances, or payments toward the deductible—and there will be no surprises. If a patient still seems unclear about the process, you could also offer to contact his or her insurance company together.

Copays, coinsurances, deductibles—oh, my. Click here to download your free copy of the PT Patient’s Guide to Understanding Insurance.

“I’ve never had to pay in your office. Can’t you just bill me like before?”

The key here is to stick to your guns—and your new payment policy (which you’ve already distributed to your patients, right?). After all, there’s a reason you’re upping your in-office collection game—namely, staying in business. So, consider saying something like this: “As you know, we’ve recently implemented a new payment policy, which you had the opportunity to review before your appointment. This is in an effort to help us streamline our billing processes and thus keep costs down—for our practice and our patients. It’s actually customary to pay for healthcare services at the time of service, so, would you like to pay by cash, check, or credit card today?” According to the NCFH, when you’re making an unpaid balance collection call, you should be “professional—polite, courteous, and businesslike.” And we think that’s great advice for any payment-related conversation.

“I didn’t bring my [payment method].”

You can overcome this objection by simply accepting multiple methods of payment: cash, check, and all major credit cards. That way, you can say something like, “Well, payment is due at the time of service. Would you like to pay via [alternate option] or [alternate option]?” If your patient doesn’t have cash, check, or credit card on hand, consider asking him or her to call home to get the card number—or, in some cases, you could ask the patient to go home and either call back with a credit card number or return later that day to pay. If you do offer this option, make sure to get a verbal commitment from the patient that he or she will actually follow through. As long as your payer contracts allow it, you may also want to consider keeping a credit card on file for your patients. That way, you can automatically charge the necessary amount without having to worry about forgotten payment methods. (For some great strategies to overcome objections to leaving a card on file, check out this infographic.)

“I can’t afford to pay this right now.”

While there are many reasons you should avoid waiving or discounting copays, it may be appropriate to do so in some cases, specifically if you have a consistent policy in place and a patient meets stringent financial hardship criteria. Otherwise, you can implement a payment plan that enables your patients to receive the care they need and pay for it in specific increments within a mutually agreeable timeline. Whatever you decide on, though, set clear expectations as to how much, when, and how your patient must pay. Then, get it in writing so everyone’s on the same page. The NCFH recommends saying something like, “So, let’s review: you will pay $50 every month for six months to pay off your $300 balance. I’m very pleased we were able to work out a payment plan that will get your account up to date. I will expect your first payment of $50 on January 1, and then every first of the month through June 1.” The NCFH then recommends providers “follow up with phone calls immediately if payment [is] not received on time.”

It’s not always easy to challenge patient objections—especially when it comes to a sensitive topic like money. But, doing so is critical to the financial health of your practice. What are the most common patient payment objections you hear in your practice? How do you overcome them? Tell us your strategies in the comment section below.