Giving credit to get what's due: How doctors can help patients pay the bill

Your waiting-room sign says, "Patient portion must be paid at the time of service." But what if your patient can't pay? Setting up a payment plan could be the answer.

By Dave Hansen, AMNews staff. Jan. 21, 2008.

With more Americans uninsured or in high-deductible plans, experts say collecting the payment portion of bills is getting more important -- and challenging -- for physicians' practices. One solution many recommend to avoid the high cost and hassle of collection is setting up payment plans for patients.

"Doing retail business with patients is now part of the permanent financial profile of being a doctor," said Brandywine Healthcare Services President Robert Burleigh, a past president of the Healthcare Billing and Management Assn. "They have to be prepared. So they should have prepayment plans. This is just the part of the business of medicine."

If a practice wants to set up payment plans, the best thing, experts say, is to determine how such plans would work before sitting down with a patient who needs or requests such a plan. How much is paid up front? How much is the monthly payment? What happens if a patient misses a payment? And should you manage the plan yourself, or bring in an outside firm or credit card company to handle it?

The overall goal, experts say, is to increase your collections while making care more financially feasible for patients. Susan Miller, RN, of Lexington, Ky.'s Family Practice Associates, a 10-physician practice, said that in her experience, letting patients pay over time produces better collection rates. "When you turn a bill over to a collections company, they will charge 30% or 40%," Miller said.

But experts say the success of payment plans relies in part on making sure they are not overused.