When You Send Patients to Collections

Question: My physicians would like me to retain patients after we send them to a collection agency; however, these patients must maintain a zero balance. Consequently, these patients must pay their copays, deductibles and coinsurances [at the time of service]. I would like to know if you are aware of other practices who have instituted a similar policy, and the result of [such a] policy. Could you share information on the ROI, labor hours associated with this [type of] policy? Additionally, the practice is pain management which means we serve a chronic population, and these patients will need frequent medication refills on a regular basis.

Answer: Being upfront with your patients is key in maintaining your patient balances. They need to understand that ignoring the monthly statements is not part of your practice's policy. A good rule of thumb is to send three statements (one each month), and if the patient does not make a payment or set up a payment plan, then you should be sending a 15-day pay or go-to-collections letter. This can be a very simply stated letter that says if the practice does not receive payment, or the patient sets up a payment plan, then the result will be collections.

You will need to set up an easy process to monitor these letters. If you do not receive payment then placing patients into collections is your next step. A great collection agency is TransWorld. They have a high recovery percentage, much better than any other I've interacted with. The sooner you get patients into collections, the more likely you are to receive payment.

One thing that I've learned is that staff in the billing department are not bill collectors. They understand insurance and denials, not collecting monies from your patients. You really should leave that up to the professionals at the collection agency. They have been specifically trained in negotiating, communicating, and understanding the different types of debtors.

So, now you have placed a patient in collections, but they want to continue being treated at your practice. What do you do? Simply set them up on a payment plan. Contact your collections agency and tell them the patient wants to return to your practice for more treatment, and you have agreed upon a specific payment amount that they will pay weekly, bimonthly, or monthly. (See Payment Plan Example.)

I know that it is difficult at times to talk money with patients, but by setting the expectation up front, you are more likely to collect your copays, coinsurances, and deductibles from patients. Being consistent and following your own set policies will also show patients that ignoring your policies is not an option for them. If you tend to pick and choose who you impose your policies on, you will have a much more difficult time collecting patient balances.