fix this practice
Collect What You're Due
A lax collection policy could leave your practice unable to stay afloat.

Q: My 15-year-old practice is growing, yet my cash flow is always a problem. In reviewing my accounts receivable, it seems very high. Please help

Dr. Z. Schula via Email

A: If an owner has check and balance systems in place and keen awareness skills, this should not occur. The common causes and solution of poor cash flow are as follows:

� Optometrists practicing in fear of the patient. These doctors are afraid patients will leave the practice if they are subjected to fair rules of collecting fees. I perform consulting services for M.D.s, dentists, chiropractors and podiatrists and this collection issue is almost non-existent. I hate to voice this thought, but many O.D.s have low professional self-esteem. These are learned behavioral patterns that you first must recognize and admit. Once the realization wakes you up, it's critical to alert each family in your database confirming your new collection policy.

In these practices, the doctor hangs around the front desk, giving patients the opportunity to ask him directly if the office "can bill them later." O.D.s who put themselves in this situation almost always cave in to the patient's request. Remember:

1. Don't stay near the front desk when your patient is paying fees.

2. If patients ask in the exam room if the office can bill them later, answer: "The front desk staff handles all financial matters."

� Outstanding bills. When evaluating clients' accounts receivable I commonly find huge amounts of money outstanding from medical procedures. If you are contracted with a managed care medical carrier, collect the co-pay in full at each visit. If it's an open medical plan (not managed care), your staff should call for prior authorization to determine if and what the company pays. Attempt to determine if the deductible has been met. If your staff has any doubt about the eligibility of a patient, collect. My consulting company has been exposed to these situations so often, I have learned this caveat: For every ten patients who leave your office owing money, six will become a collection problem. 

� Overriding collections policy. Doctors, do not make the mistake of developing a policy on collection and then constantly override your staff. This leads to low morale and high turnover. Your staff perceives that if you break this policy, you won't support them in other standard operating procedures.

Don't loan services

Brothers and sisters in optometry, wake up. You are not a bank. When you allow a patient to leave your office owing you money, in essence, you have made a loan (many times with no interest). I.B.M. states that it costs you $2.50 to send one statement. In 2006, consumers believe if they fill out an insurance form and the insurance didn't pay you, it's between you and the insurance company. They can't call a contact lens retailer and place an order without paying in full. Patients don't leave a corporate practice without paying. The only way a lax collection policy distinguishes you is that you can't pay bills on time.

As the owner, you must be the steward of the money. You have a responsibility to your family, staff, vendors and organization. Set the policies, enforce them, be aware of finances, evaluate accounts receivable monthly and enjoy a less stressful career.

DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT  ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.