Asking for money is never easy. It can feel awkward and is often avoided by the very people that you rely on to maintain your Revenue Cycle Management (RCM) process. The reality is straightforward—once an outstanding balance goes to a collection agency, on average, it’s worth less than $20 on each $100 submitted…an 80% write off that is avoidable!
To compound this issue, patients are assuming a much larger portion of the costs through high-deductible health plans, which have shifted more than 30% of the payment responsibility directly to the patient. This is why it’s more critical than ever to have strong, well-defined financial policies that are clearly communicated through multiple avenues to your patients.
Shifting Responsibility to Collect Patient Payments
With today’s technological advances, it’s possible to verify a patient’s insurance eligibility in real time, estimate their remaining benefits and project a definitive estimate of what will be due at an upcoming appointment. Utilizing clear and precise scripting to collect amounts due prior to a patient’s visit will significantly improve A/R and the RCM process. In a pre-collections call, a patient can be made aware of the amount due, pay through options available during the call, and ask any questions ahead of their visit.
With scripting suggested by the American Medical Association, you are able to not only communicate the projected balance due but also educate the patient on their insurance coverage and limitations. As an example:
“According to your insurance benefits, your financial responsibility includes a $10 copay,
10% coinsurance and a $1,000 deductible. Your insurance company indicates that you
have met $500 of your annual deductible. Based upon services that will be provided during your appointment, and after combining the $500 remaining deductible, copay and
coinsurance amounts, the total amount you will likely owe at the time of service is $310. I will be happy to walk you through the price estimation if you’d like.”
7 Tips to Remember as You Develop Patient Pre-Collection Scripts
With the goal being to collect patient payments in advance, it’s helpful to remember that front office staff members are often reluctant and would benefit from participating in the development of scripts and the pre-collections process. With training, realistic expectations, and a sense of accountability, your front office staff can and should be an engaged participant in the RCM process.
When developing training and scripting, remember these tips:
1. Be human – When talking with patients, whether on the phone or in person, it’s important to be empathic and relatable. Remember the person may be sick and not feeling well, having financial constraints, or in many cases, doesn’t understand their insurance coverage.
2. Avoid open-ended questions:
“I see you have a $50 amount due. Are you able to pay today?”
Instead, try “I see you have a $50 amount due. Would you like to use Visa or Mastercard to pay your balance today?”
3. Provide realistic payment options – Always start by asking for the full amount. If there are issues, you’ll be able to offer solutions according to your financial policies (and it makes you the hero) such as:
- An existing credit card on file
- Automated recurring payments
- Financing options
4. Invite questions – every opportunity to educate the patient should be appreciated. If they have questions, give them the respect to answer them fully.
5. Maintain eye contact – No one should feel bad or apologize. You provide an excellent service and deserve to be fairly compensated for it.
6. Prepare for objections – Objections are inevitable, so why not create a list of anticipated protests and craft proactive and reasonable responses. This helps staff members to overcome any fear or trepidation they may be feeling in this whole process.
7. Role play – During staff meetings or as a team building exercise, role play financial conversations (for added emphasis – use real examples, names changed of course).
The ability to effectively collect patient payments defines how effective your RCM process is and, if there is a problem, shows up in your A/R often as uncollectible debt. With a comprehensive and proactive training and scripting program, your staff members can pre-collect amounts due in accordance with insurance providers’ regulations. In the end, patients that are well informed are more likely to have a positive visit and continue to use you as their provider.
Contact us today to request a report card and boost your pre-collections program.
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