Collections

ILLUSTRATION BY MARTIN WICKSTROM

Collections Made Easy

Two simple solutions can take the anxiety and inefficiency out of in-office collections.

Neil Gailmard, O.D., M.B.A., Munster, Ind.

“How much did you want to put down on that today?”

I cringe when I hear that question. Although it seems innocent and even logical to the untrained — after all, the staff member who asks must have this information to print the receipt — we may not like answers such as “No, I don't want to put anything down.” Or, “I think I'll put $10 down” (on a $600 order).

Some practices correct this error by next explaining office policy, for example, that 50% down is required at the time of the order. But invoking policy is always used to say “no.” In this case, the patient feels bad, like he's trying to be cheap. I want our staff to say “yes” whenever possible.

Simply stated

The solution? Train the staff to simply state the total charges incurred at checkout. For example, let's say the patient's fees total $730 for an eye exam, contact lenses and glasses. As the services and materials are selected, the technician explains the fee breakdowns and writes them on the superbill. The technician escorts the patient to the business office counter, introduces her to a receptionist, who would say, “Mrs. Smith, your charges today are $730.” Period.

The result? The patient often pays the whole amount. In cases in which the patient asks whether he/she has to pay the total now, we reply that only a 50% deposit is required (with the balance due upon dispensing). This sounds so much nicer than the office policy scenario.

In cases in which we accept some amount directly from an insurance plan, we state the amount and deduct it from the patient's total.

Advance information

In addition to stating total charges, my staff implicitly follows one other rule: We always explain our fees in advance. So, we never have a patient who isn't prepared to pay or thinks we accept his insurance when we don't. Because we universally follow this rule, we're never in doubt about whether the patient was informed.

Here are the four steps a receptionist takes to implement this procedure:

1. After setting the time and date and obtaining all the appointment information, ask the patient whether he intends to use an insurance plan or Medicare.

2. If he states a plan that your office accepts, tell him that you are a provider for that plan and that you'll need his plan I.D. number to verify benefits. If the patient does not supply the needed information so that you can verify coverage, treat him like an out-of-network patient (see #3).

3. If he states he uses a plan that you don't accept, advise him that you are not a provider for that plan, but that he can pay your fee and file his own claim for reimbursement. This is usually acceptable, especially if the patient was referred and has already decided to use your services. If it's not acceptable, find out now. State the typical exam fee, and mention that it is due at the time of service. If you must state a range, do so, but it's better to provide the actual fee for this first visit. State that contact lens service fees are additional, and discuss them if applicable.

4. If he states that he has no insurance, state the exam fee and payment expectation as stated above. Discuss additional fees for special diagnostic testing, eyeglasses and specific contact lens materials in the office, as the patient can say “yes” or “no” at that time.

Collections are only a small part of our interaction with patients, but a part about which they want to know. The phone steps may seem like a lot, but I'll bet your staff will happily and consistently want to perform them. After all, they have to deal with the payment issues. OM

Dr. Gailmard is CEO of Gailmard Eye Center and COO of Prima Eye Group, an alliance of independent optometrists. He is also a faculty member at Illinois College of Optometry and a frequent lecturer on practice management. E-mail comments to optometricmanagement@gmail.com.