Get a handle on your collections
An important part of managing the physician practice is addressing outstanding patient balances and taking the necessary steps to receive that balance before sending the patient account to an outside collection agency. The AMA and the Ohio State Medical Association (OSMA) developed the educational resource "Internal collections in the physician practice" that discusses the importance of collecting from the patient at the time of service and provides useful tips and recommended steps for implementing a collections policy. This resource also includes sample template letters and practice policies to assist in developing physician practice policies.
The co-payment and deductible collected at patient check-out may seem to be a small amount at first glance. However, the importance of this collection is evident when taking the following formula into account:
Amount of patient co-payment
Number of patients seen in one day
Approximately 260 billable days per year
Amount of co-payments collected
Failure to collect co-payments and deductibles can add up to considerable lost revenue, especially as deductibles continue to rise. It also costs the physician practice additional time spent billing and collecting the co-payments after the fact.
The registration, clinical coding and billing staff should maintain a reporting relationship that reinforces the role that each staff member plays in ensuring accurate claims entry and routine collection of patient co-payments. Developing a report card with the following performance measures may assist the practice staff in this joint effort. Visit Prepare That Claim for a sample physician practice report card: Staff productivity expectations (Table 3, page 23) .
Access "Prepare that claim" for more information on this topic. "Appeal that claim" and "Follow that claim" were also developed to help physicians and their practice staff to review the efficiency of their current internal claims management process, as well as understand the payer’s role in the claims process. These resources contain sample forms and policies that can be adapted to fit the specific needs of a physician practice, including the above sample physician practice report card.
Access toolkits to help you effectively use key Health Insurance Portability and Accountability Act (HIPAA) electronic health care transactions in your practice, including eligibility, claim status, electronic funds transfer and prior authorization. Don't wait—start experiencing the savings!
Learn how to select a practice management system that will reduce your time spent on manual administrative tasks that occur throughout the claims revenue cycle and replace them with automated solutions.