Make patient collections an integral part of your practice

April 1, 2011

The economic downturn has certainly affected your dermatology practice, decreasing patient volume and employee morale while increasing your overhead. The most significant challenge, however, may lie in the impact of the recession on your patients.

Key Points

Not only have more Americans lost their health insurance - 22.5 percent of all nonelderly adults are without insurance today1 - but those with employer-based insurance are responsible for more of their healthcare costs. Add in the impact of more high-deductible health plans among employer-based and individual plans, and the reality is that your patients - insured or not - owe you more of your bill than in recent history.

These trends do more than challenge the bottom line of many medical practices - they change the landscape. Since the initiation of Medicare in 1965 (and in the preponderance of commercial insurance that followed) insurance steered our billing and collections processes. The experience and expertise of practice employees, as well as information systems, are directed toward handling insurance claims.

Minimum deposits

Do you have a minimum deposit for uninsured patients? It's essential in today's environment to establish a minimum deposit for patients without insurance, or for those with an insurance plan you don't accept. Recommended to be at least at the average copayment for commercially insured patients in your community, this charge may be all you collect from patients without insurance. For cosmetic services, continue to expect payment of the full charge for your services upon the patient's arrival.

Payment plans

Do you offer your patients a viable payment plan option? Payment plans are a necessity to accommodate patients in today's challenging economic environment, but you can quickly lose out when the terms work for the patient and not you. Skip the '$5 per month for 20 years' plan. Instead, set a minimum monthly payment ($50, for example) and a maximum duration (six months, for example). Before offering six-month plans, ask patients, "How much more time do you need?" They often will respond with a shorter deadline than you would have offered.

Remember, managing payment plans consumes precious staff time. Consider outsourcing the process to a company that specializes in healthcare loans, or use one of the new, Internet-based "credit card hold-and-pay" vendors. With "hold-and-pay," you agree on a plan, to include payment in full after the patient's insurance has paid, then you key in the parameters of the plan (in addition to the patient's credit card information) on a secure website. Based on your agreed-to plan, the patient's credit card is automatically debited (and funds are transferred to you), and a receipt for the transaction goes directly to the patient.