Encouraging Patients to Be Compliant

The current economy is difficult for everyone. It is very difficult for medical practices to ensure that their patients remain compliant with routine office visits and taking medications in these times. I will share some of my practice's methods for encouraging patients to be compliant.

Any medical practice office manager will tell you that the only way to keep the staff busy is to encourage patients to schedule follow-up appointments at the time of check out. We have all seen this in our day-to-day work flow. Patients will call the office for medication refills, scheduling of tests, etc., and will only do so if the office staff allows them to do so without a physician visit. This is the only way that we can adequately cover our expenses for the reception and nursing staff. We must keep the schedule as full as we possibly can. Certainly with the difficult economic times we have all witnessed patients calling for medication refills without an office visit. Our policy is to refill medications as needed so that our patients will not have a lapse in their therapy. However, we must take care not to encourage poor behavior from our patients. We keep a record of repetitive refill requests and after such a request is granted once, we require that a follow-up visit is scheduled and kept before subsequent refills are given. Be firm with the policy and the patients will comply.

For our patients that have somehow built up a large balance, we encourage them to set up a payment plan. Once a problem patient is identified, we require them to pay their co-pay up front before any services are rendered. For the patients in our practice, this constitutes about 5 percent to 10 percent of our patient panel. We hear every excuse ranging from "I forgot my checkbook" to "I just can't afford the copay right now." Again, we are very forgiving and understanding of our patients' economic woes, however policies are put in place to not encourage repetitive bad payment behaviors. It has always been my experience that patients who build up large balances end up not being compliant with taking medications, getting preventive tests scheduled, etc and once those problem patients are identified, we do not provide services for them until a payment plan has been put in place. Certainly a small percentage of those patients will elect to transfer their care to another practice, however those patients are ultimately problem patients and our practice is better off without them.

We do offer a percentage discount to those patients if they elect to pay off their balance in lump sum. Offer them a 10 or 15 percent discount if they pay off their balance in full. It is far better to collect 85 percent to 90 percent of a balance rather than zero percent. This practice has been generally well received by everyone, however, we do not offer a continuous discount to those who have large balances. The best practice is to encourage the reception staff to collect all co-pays and balance payments at the time of service so that the large balances do not add up.

It is also important to ensure that patients who are compliant with their therapies and follow up are positively encouraged to remain compliant. Patients that keep themselves healthy are reminded that keeping such good medical behaviors will insure that the frequency of their follow-up visits will be decreased. Such behavior will not only allow the patients to remain healthy, it will also decrease the complexity of their follow-up visits and will result in the physician being more efficient with their time. This can also result in possibly one or two more open slots being available for scheduling other visits during the day.

Everyone is being pressed by our current economic situation. Insurance plans are forcing patients to have higher co-pays, higher deductibles, higher out of pocket prescription costs and ultimately this can have a devastating effect on a medical practice's cash flow. However you choose to positively encourage good patient behavior, always remind your patients that you will always strive to be as conservative with their medical dollars as you can.

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