How to Implement a Patient Fees Collection Plan in Your Practice

Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.

Yesterday, I discussed the importance of not waiving patient fees. So what to do instead? Develop a system or procedure to collect all patient fees (including copays, deductibles, coinsurance, and payment for non-covered services and supplies) at the time of service. Here are steps based off an article from the APTA.

1.) Establish and enforce written policies and procedures for copay and other fee collection. Make sure you cover everything, including how the front desk will determine fees, what the is process for patient acknowledgement, and ways you’ll collect payment. To facilitate this collection, consider these:

• Get a credit or debit card transaction machine.
• Keep sufficient petty cash on hand to make change for those paying cash.
• Depending on your location, talk with a local bank about installing an ATM in the lobby of your building to encourage cash payments.
• Provide a mechanism for bill payment on your website.

2.) Educate and train staff. Share, explain, and emphasize the importance of the financial policies with both administrative and clinical staff. Additionally, ensure therapists discuss the issue of out-of-pocket costs with the patient while reviewing the plan of care to help ensure the patient reaches his or her goals. The therapist may need to adjust the frequency and duration of visits, and it’s good to know that up front.

 Furthermore, consider developing a script for the front office staff and having them practice. The script should include techniques and best practices. For example, according to the APTA, most practices find they get the best response by asking "How would you like to pay? Credit card, cash, or check?" rather than by asking "Would you like to pay your copay today?"

 You may even want to consider developing an incentive program for the front office staff based on their collections. Establish goals that you can measure and they can achieve. The increase in collections will more than offset the costs of an incentive program.

 3.) Inform patients. Emphasize the benefits and practicalities:

• Collection at the time of service is standard business practice for the medical industry.
• Payment at the time of service prevents amounts owed from accumulating and becoming overwhelming.
• Fewer bills minimize the cost and hassle.
• This policy fulfills obligations to payers. Insurance companies require patients to pay copays and deductibles, and they require practices to collect them.

4.) Make sure patients understand the policy.

• Post your payment policy in a prominent location on the website.
• Display signage.
• Explain the policy over the phone when a patient calls for an appointment.
• During the first visit, have the patient read and sign a form indicating his or her understanding of, and agreement to, the policy.
• Consider sending a letter of explanation to current patients. At a minimum, explain the new policy in person to each patient. Have each patient acknowledge acceptance in writing.

5.) Set the policy and stick with it. Strive for a time-of-service collection rate of 90% or better.
When patients schedule appointments:

• Obtain their insurance information.
• Explain your collection policy.
• Remind them to bring their insurance cards, identification (e.g., driver's license), and payment to their first visit.

When patients check in for their first appointment:

• Verify their insurance and payment information.
• Make a copy of their insurance card. Have the patient read and sign the agreement guaranteeing payment.
• Establish the method of payment.
• Give patients the option of keeping a credit or debit card number on file.

At the time of service:

• Collect the copay and other fees—preferably at the beginning of the visit.
• Ask for authorization to automatically debit or charge for services that are not known at the end of the visit. You should be able to provide a verbal estimate in most cases.

A few more pointers:

• File electronic claims within 24 hours of the visit.
• Collect past-due accounts in the office. Don't wait and send a bill. Payment plans should be the exception and not the rule. Save them for cases of true hardship, and make sure you have specific policies and procedures governing their use. 

This may seem like a lot to take in, but it is business critical. Implement these steps and eliminate risking your practice or ruining your business. Most importantly, implement these steps to further prove your worth. Always remember: you deserve to get paid; your services are worth it.