5 1 A Prescription for Patient Receivables

Why do providers have such a hard time collecting from patients?  Because healthcare providers are in last place when it comes to consumer payments!  Because consumer perception is that doctors have lots of money and live a wealthy lifestyle … and therefore do not need timely payment 5 2

How do Americans pay their bills?  House Payment  Car Payment  Utilities  Bank & Credit Card Payments  Food & Gas  Clothing  Kids’ Expenses  Entertainment  Vacation  Everything Else  Doctor, Dentist & Hospital – YOU! 6 3

 The Affordable Care Act is shifting an increasing number of healthcare expenses to the patient through higher- deductible plans  The economy is still suffering and unemployment remains high  Many patients feel the doctor is well- compensated through payor payments and co-payments  Patients are in the habit of delaying healthcare payments Do you think the problem is going to improve? 7 4

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 More of the same (usually with the same results)  Write it off as bad debt  Hire a collection agency  Refuse to accept insurance and require total estimated payment at the time of service  Collect a large deposit at the time of service  Credit/debit card “signatures-on-file” What techniques do you see providers using to collect patient payments? 9 6

 More of the same (ignore dunning notice and collection call)  Collection agency (not happy but know it won’t affect their credit in most cases)  Write it off as bad debt (patients are ecstatic)  Refuse to accept insurance and require payment at time of service (panic)  Collect a large deposit at the time of service (panic) How do patients react to these techniques? 10 7

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 Credit/debit card “signatures-on- file” (properly introduced, patients will generally provide a “signature- on-file,” if they intend to pay you)  Patients like not having to pay immediately and will mostly accept providing a “signature-on-file”  Those with no intention of paying will go elsewhere (a good thing) How do patients react to these techniques? 11 9

 Visa consumer research shows that patients who are paid up will return to the doctor … patients that owe money will go elsewhere (keep your patients current on their bills and you keep your patients)  You want patients with no intention of paying you to go elsewhere! What about patient retention? Will patients go elsewhere? 12 10

 No … it will expedite it!  Fewer collection calls and dunning notices  Less check processing  Automated posting to the ledger with some practice management vendors  You are now in control of when you get paid by the patient (after final adjudication)! If providers implement a “signature-on-file” program, will that disrupt office workflow? 13 11

 Set an office policy for large amounts owing  Call each past due patient … ask them to pay the balance today  Expect an excuse, to which you say, “I understand. If you’ll just give me your debit/credit card, then I won’t have to call you again.” (or offer payment terms per your policy) What about patients that currently owe money? What are the best ways to collect from them? 14 12

 If the patient won’t give you a debit/credit card, ask them directly if they intend to pay you  If “no,” turn over to the collection agency  If “yes,” ask them when and how. If they say 2 weeks, then ask again for credit/debit card and tell them you will not process the payment until the designated time. Enter the info into your credit/debit card software. What about patients that currently owe money? What are the best ways to collect from them? 15 13

 Offer the front office staff $1 for each “signature-on-file” they get from patients (for a limited time)  Instead of collecting from patients costing $30-50 per visit, it will now only cost $1 (plus the credit/debit card fee)  You will save significant dollars on collection/billing costs (not to mention bad debts) and your front office staff will be very happy with the temporary “raise” How do providers get the front office staff motivated to ask for “signatures-on-file”? 16 14

 In less than a month  You will want to send a letter to your patients explaining that faced with rising costs, you either had to increase fees or eliminate some expenses … so you eliminated billing & collection  You will want to train your front desk staff with a script both for existing patients and new patients calling in to make an initial appointment How quickly can providers implement a “signature-on-file” program? 17 15

Without a “signature-on-file” program, you might have to resort to desperate measures! 18 16

 10% in 90 days  50% in 180 days  80% in 1 year  Assumes you don’t have a geriatric practice or an in- hospital practice … and that your patients have the ability to pay  “Signatures-on-file” put you in control of when you get paid (after final adjudication) What’s a realistic expectation in the reduction of patient receivables? 19 17

 No more “dialing for dollars at dinnertime”  Less stress in the office  More resources to collect payor payments  Much happier providers! If providers eliminate having to collect from patients, what will be the impact on office staff? 20 18

For general information, contact Vinson J. Hudson, POMIS Analyst, at After the talk, Mr. Hudson will introduce an executive of Easy Pay Solutions to present its valuable proposition. Thank you for viewing the slides