Developing Procedures to Cross-train Your Practice Staff

The following Sample Procedure can be used for: cross-training medical practice staff; training new employees; and/or as a refresher training tool.

Those performing the roles at your medical practice write the best procedures. They can use the following Sample as a helpful reference.

Sample Procedure

Responsibility: Front Desk Staff

Procedure: Collecting copayments and deductibles from patients

Goal:
• To reduce the costs of billing small copayments
• To reduce the money owed to the practice
• To reduce the amount of money that becomes bad debt
• To improve the cash flow of the practice

Background:
Most plans require patients to pay a copayment for each medical visit. The co-payment could be either a fixed dollar amount or a percentage of charges for each visit. And most plans also require the patient to pay the practice a fixed dollar payment (“deductible”) at the beginning of each calendar year. Our practice is required, by each of the plans, to collect the copayments and deductible amounts as part of our payment for the services. For example, if a plan is paying us $100 for a service and there is a copayment of $25, then the plan is only going to pay us $75 - we have to collect the remaining $25 from the patient.

Copayments1. Fixed dollar copays: Collect copays prior to patient seeing the physician. Copay amount is on the appointment schedule for the day and on most patient insurance cards.

2. Percentage copays: Since you are not certain of the amount of service to be provided, let patients know that you will be collecting the copay on their exit.

3. How to ask for co-pay: “Mr. Patient your plan requires us to collect a copy of $XX. How would you like to take care of this today?

4. What to do if the patient says he/she can’t pay: Suggest: “We accept credit cards.” If that does not result in payment, provide patient with a copy of the encounter form with the amount to be paid circled. Also provide an envelope addressed to the practice. Ask the patient “We’d appreciate your sending your check to us when you get home.”

Deductibles
Most plans require patients to pay a fixed dollar deductible, usually at the beginning of the calendar year. The practice is expected to collect this copayment. Our practice wants to collect these copayments rather than sending out bills. The routine is to be followed in January and February of each year.

1. How to ask for deductible: “Mr. Patient your plan requires you to pay a deductible at the beginning of the year. Have you paid your deductible of $XX at any other practice this year?”
If the patient is not certain, then:
“I know you may not be certain, but we are required to collect it in those cases. If it turns out that you have already paid it your plan will notify us and we will refund your moneys to you within 15 days. So, how would you like to pay your deducible of $XX, and I will give you a receipt as a reminder for you.”

2. If patient is unable to pay the deductible: Do the same routine as for copayments above.

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