If you are like many physical therapy practices out there, you struggle with collecting copays, coinsurances and deductibles from your patients prior to treatment. Missed collections on the front end can cause headaches and costly patient billing statements on the backend. So how can we solve this age old problem? Well, I have outlined 3 best practices on how to improve patient collections.
Step 1: The Appointment
A patient calls in to make an appointment, or maybe they’ve scheduled it via the web, nonetheless they have an appointment. This is precisely when the revenue cycle for your practice begins- right at your front desk. Upon intake of the patient, the front desk needs to collect basic demographic and insurance information from the patient that will be used to begin building their patient account in your scheduler. Can this “intake” occur on paper you ask? Sure, but utilizing the tools available in your scheduling software will save time and eliminate a few extra steps for the front desk staff. In RevFlow we have a “Quick Add Patient” feature which allows you to quickly start the patient registration process electronically. Regardless of the system your office is using, here’s a quick list of information you should try and get from the patient right when they first call to schedule their appointment.
- Name and DOB of the patient
- Insurance Carrier
- Policy number
- Group number
- Effective date of the insurance
- Address & phone number of the insurance
- Name of the insured (if different from the patient)
- Employer of the insured
- Secondary or Tertiary Insurance (if so, repeat the above questions for the secondary insurance)
Ok, so you have all the above information from the client? Great.. Now we must verify their benefits.
Step 2: Verify Benefits Before Check-In
Using the information collected from the patient will provide you with all that you need to verify benefits. The majority of verifications will occur online. Most insurance companies have their own websites, and with minimal effort, the verification of insurance coverage is attainable. If it is not, you will have to call into the insurance company. In this instance, having a prepared script or verification form for the front desk to use will eliminate missed information. A common mistake is verifying benefits for the wrong service. For instance, be sure you know if you are verifying inpatient or outpatient services. This is a common error that can cause you to collect the wrong copay or deductible amount from your patient.
Make a note of the owed copay, coinsurance or deductible amount in the patient file/appointment to assist the front desk staff in collection. Let’s take this a step further… if time allows, call the patient. Inform them of their copay, coinsurance and or deductible and what forms of payment your facility accepts. Be sure to also tell them that payment is expected prior to start of treatment. This starts a solid foundation of expectation for each sequential visit.
In RevFlow you have the ability to add the patient’s copay, coinsurance, and deductible amount and are prompted to collect from the patient when he or she is checked in for their appointment. Using functionality like this in your scheduling software will help ensure your front desk staff will not forget to collected monies due from your patients. if you are not using an electronic scheduling system, just adding a note in the patient’s chart, or a copay log will also help the front desk keep track of patient collections.
Step 3: Estimate and Collect
Your front desk is typically the patient’s first impression. The impact can be tremendous. Be sure the greet the patient. Answer any questions the patient may have. Review their benefits and inform them of their financial expectation each visit and them collect the payment.
Copays are straightforward. For example, when verifying benefits, insurance representative may tell you that the patient has $25 copay for outpatient physical therapy visits. Great! That means $25 is collected each visit.
A deductible is the amount of money a patient must pay for services before his insurance plan starts to pay. Knowledge of this amount at start of treatment is vital. If the patient has a $500 deductible, the insurance will not issue any payments until this amount is met by the patient. It is best practice to collect a small amount from the patient ($50-$100) each visit until they have paid the your office the full $500. Doing so helps avoid sending your patient a large bill after their treatment is over (which they are less likely to pay) and actually helps to motivate your patient to be an active participant in their treatment because they are now financially invested.
A coinsurance is a percentage of cost of a covered health care service a patient must pay after their deductible is met. For example, when you called to verify the patient’s benefits, the insurance representative may have mentioned that the patient has a 20% coinsurance. This means the patient will be responsible for 20% of allowed amount of charges. Having a good understanding of your practice’s contracts with your major insurance payers will help you estimate how much you should collect from the patient each visit. Having a key or reference sheet up front isn’t a bad idea either. For example, if your contracted rate with Blue Cross is $100 per visit and the patient has a 20% coinsurance, the amount to collect each visit would be?
…Oh there you are… yes it would be $20.00. Collecting an estimated coinsurance amount each visit again helps the patient, so they won’t get stuck with a big bill at the end of treatment, and helps your practice because you avoid the headache of preparing and sending out patient statements and trying to collect from the patient.
A fully integrated scheduling, EMR, and practice management software like RevFlow includes features that will assist your practice with collecting payments from the patient prior to treatment. Incorporating the tools available in your software and the best practices outlined in this article will help your physical therapy practice collect more from the patient’s upfront and in turn will reduce collection efforts on the backend.