Patient Collections - Part 1

Patient collections is a very important part of the medical billing process.  It doesn't always end when a claim gets processed by insurance.  If the patient also owes a balance, it's important to collect it as soon as possible, especially early in the year when most claims don't get paid but instead applied to the patient's deductible.  Sometimes it's easy to lose sight of patient collections when insurance collections are usually the main focus.  As long as you have a good system in place, patient collections should not take too much of your time.  Today I will go over printing statements, marking statements and sending letters.

PRINTING STATEMENTS
The frequency with which you should print and send your statements depends entirely on your schedule, your preference or how big your office is.  Right now I work for a small office and run a different letter range every week.  For example on the first week of the month I run all statements for patients whose last name starts with letters A through F.  The second week of the month I run all statements for G through L and so on.  This format could work for big or small offices.  I like it because it keeps the work consistent week to week.  But if you work in a small enough office and you would rather send them all out at once you could print out all your statements once a month. 
Some small offices will also print out a statement as soon as the patient has a balance.  For example if you were posting an explanation of benefits and after the payment and adjustment the patient still owed a balance, you could immediately print a statement and send it out to that patient.  Some billers prefer to do this with the hope that the sooner the patient gets the statement the sooner they will pay the bill.  I don't use this method, but I will say that if it is a large balance and the patient is not due to receive a statement for another few weeks, then I could see it being beneficial.

MARKING STATEMENTS
It is likely that large practices with multiple locations do not have the time or manpower to look at each individual statement and mark or stamp it if the balance is overdue.  If you do not work for a large practice however, I would highly recommend that you do.  By stamping a statement or marking it in some way you are reminding the patient that this is their second or third time receiving this statement and showing them that your office is keeping track.  If they got the same bill month after month without anything that said second or third notice, they might think they can get away with not paying the bill for a few more months.  But by getting those notices stamped on the bill, they might start worrying about their account being turned over to a collection agency and they will pay the bill sooner. 
When it comes to marking statements there are a couple of options.  If you are sending a statement to a patient for the second time you could use a 2nd notice stamp and then a 3rd notice stamp when you send it the third time.  Or if you don't want to have to worry about keeping track of how many times you send each statement you could wait until the balance is more than 60 days old and then simply use a Past Due stamp.  Whatever method you choose, make sure you stay consistent. That way they'll know you mean business!

LETTERS
It is important that you communicate with your patients through letters when their balance is past due.  A letter is more noticeable than a bill and, if you keep a copy, it is proof that you exhausted all efforts before turning the account over to collections.  I used to work at a place that would send the first 3 statements and by the 4th we would send the statement with a letter signed by the doctor notifying the patient that if the bill was not paid in 10 days the account would be turned over to collections and they would not be able to come back to the office moving forward unless it was an emergency.
The place where I work now isn't quite as drastic.  We send a letter with the 3rd statement letting them know that their balance is past due and prompt payment will avoid the account being sent to collections.  By the 4th statement we send a final letter telling them they have 10 days to pay the bill before we turn the account over to collections.  We do not however tell them that they can no longer be seen in our office. 
How strict you want to make these letters and policies moving forward is up to you and/or the doctors you work for.  The important thing is to communicate with the patients in writing before sending the account to a collection agency because this will affect their credit and you need to have proof that you did inform them beforehand.

The three topics discussed above are the foundation of patient collections.  In my next post I will cover some other tricks of the trade that will make patient collections easier to track and will tell you how to successfully make a collections phone call.