Medical Billing Forum

Payments => Patient Billing => : DMK July 31, 2013, 07:25:55 PM

: Polite / Nasty / Collections
: DMK July 31, 2013, 07:25:55 PM
I have a few patients who, for one reason or another, don't make regular payments.  I have tried the polite note, the firmer note, the past due red stamp, and the FINAL NOTICE stamp.  It rarely takes a firm note to get people to pay, but I have a few that need to go out this next cycle and would like to ask others what they write on their statements that are seriously past due?

The amounts are small enough (up to $300) so their not really worth the bad press to take them to collections, but that's money we could be using to pay our bills!  We do offer credit card payment, even over the phone if they find it hard to write a check.

Any suggestions?
: Re: Polite / Nasty / Collections
: PMRNC July 31, 2013, 07:56:36 PM
We refer out to collections. We do it every 90 days for all clients. Aside from that what are you going to do aside from write it off?
: Re: Polite / Nasty / Collections
: PMRNC July 31, 2013, 07:57:08 PM
Just make sure you NEVER threaten collections and not follow through, that is a violation of the FDCPA
: Re: Polite / Nasty / Collections
: DMK July 31, 2013, 09:12:07 PM
I write it off after a year of trying to collect.  And we're lucky, there's only a few each year and not usually for a lot of money.  The patient usually needs to see the doctor again at some point and pays the old balance, and I don't let them carry a balance anymore.

I never threaten collections, I learned a long time ago that you can't threaten and not follow through.

I'm looking for a "nice" but "firm" way to say "hey! pay your bill!"
: Re: Polite / Nasty / Collections
: RichardP July 31, 2013, 10:06:56 PM
At what point do you follow up with a phone call?
: Re: Polite / Nasty / Collections
: rdmoore2003 August 01, 2013, 01:07:47 PM
Why do you not send the accounts for collections?  My invoices are sent every month with notes like account seriously past due, etc.  After invoices are sent, a letter is sent out with information concerning the account being sent for "special handling" and it is sent.   In my state, as long as it is documented on the monthly invoices about special handling process which incurrs an additional fee, once the account is sent, the fee is added to the account that patient is responsible for.                  Ex.  account owed is 100.00 and when sent to collections the amount sent is $135.  Our state allows a 35% collection fee.
: Re: Polite / Nasty / Collections
: PMRNC August 02, 2013, 12:31:27 PM
Interest charges and collection fees generally don't work when you just have patients ignoring statements. You can try a few "soft collection methods" such as stickers, try the official looking envelopes they seem to get opened.  Also your PM software should allow you to place dunning messages on patient statements. Self addressed stamped return envelopes seem to work too and sometimes we will include a small form for them to sign a payment plan by using their credit card. Keep in mind that adding those interest charges and collection fees can sometimes backfire. A patient can actually pay JUST the amount they were supposed to and you'll be writing off anyway because they would win if fought. Laws are mostly for the consumer.

If you are writing off every year you should run a report to show the provider what's being lost. I had to do this a few years ago and now my clients REGULARLY follow a pretty strict procedure and we send it. If it's 500 a month or 5000 it's still $$.
: Re: Polite / Nasty / Collections
: DMK August 02, 2013, 01:28:04 PM
Thanks for all the responses.  It's good to know I'm doing it the best I can without resorting to collections.  The reason we DON'T send to collections is that this is a small town and the rumor mill can kill your business. ("That rich doctor sent me to collections!")  The reason I rarely call is that I'm the doctor's wife.  It looks like I'm a money grubber.  I do call and verify that I have the correct address (playing dumb) or to explain that they have a co-pay or deductible (you'd be amazed how many people say "I have good insurance" and that's supposed to mean that they don't have to pay anything out of pocket.

It's a sticky situation and I'm trying to remain professional.  It's not a lot of money each year, but it's the principle.  I pay my bills, why don't others pay their bills?
: Re: Polite / Nasty / Collections
: gurumedbill August 02, 2013, 01:31:50 PM
Our software has a collections wizard that will allow you to filter a certain group of people and send them to collections.  I don't bother with the people that owe less than $50 but if you owe me more than that then I send them to collections.  Fortunately it isn't a lot of people for most practices I bill for.  When I do send them to collections they still don't get everyone but they get more than half of the people and it is certainly worth it for me.
: Re: Polite / Nasty / Collections
: PMRNC August 02, 2013, 08:58:54 PM
The reason I rarely call is that I'm the doctor's wife.  It looks like I'm a money grubber.  I do call and verify that I have the correct address (playing dumb) or to explain that they have a co-pay or deductible (you'd be amazed how many people say "I have good insurance" and that's supposed to mean that they don't have to pay anything out of pocket.

YOU cannot make that an issue. That fact actually has to account for ZERO when it comes to the practice collections.

Our software has a collections wizard that will allow you to filter a certain group of people and send them to collections.  I don't bother with the people that owe less than $50 but if you owe me more than that then I send them to collections.  Fortunately it isn't a lot of people for most practices I bill for.  When I do send them to collections they still don't get everyone but they get more than half of the people and it is certainly worth it for me

Software has ZERO to do with dealing with the federal and state regs. ANY software can produce a collections report. it's not up to the software to deal with state and federal collection practices.
: Re: Polite / Nasty / Collections
: gurumedbill August 05, 2013, 12:44:00 PM
Software has ZERO to do with dealing with the federal and state regs. ANY software can produce a collections report. it's not up to the software to deal with state and federal collection practices.

I guess I wasn't clear enough in my last post.  After the collections wizard in my software produces the file it gets uploaded directly to a collections company that does the collections (that is what I meant by being sent to collections and "'they' still don't get everyone").  I don't have to worry about the state and federal regulations because the collections company does all of that stuff for me.  Which is a another benefit to using a collections company so I don't have to worry about knowing all the regs of all the states for all the different practices I bill for.
: Re: Polite / Nasty / Collections
: rdmoore2003 August 05, 2013, 05:35:11 PM
I guess I have lucked out with our collections agency.  Once that percentage is added to the account and sent, they are awesome.  I dont really have a large number of accounts with them.  However, I can spend the entire day on the phone and get the runaround but the moment the agency contacts them, 95% of the time, they receive payment in full and we get our $$.  It's something about that 30 days the agency gives because they sure dont want it on their credit report (even though medical expenses is not suppose to  really "damage" your rating).   Another issue, if the patient sends the payment to us, we endorse it and send straight to the agency, because once they have it (the account), there is a fee and we are not paying for it, the person that owes will pay...
: Re: Polite / Nasty / Collections
: PMRNC August 05, 2013, 05:39:19 PM
I guess I wasn't clear enough in my last post.  After the collections wizard in my software produces the file it gets uploaded directly to a collections company that does the collections (that is what I meant by being sent to collections and "'they' still don't get everyone").  I don't have to worry about the state and federal regulations because the collections company does all of that stuff for me.  Which is a another benefit to using a collections company so I don't have to worry about knowing all the regs of all the states for all the different practices I bill for.

I understand that. Most billers do not understand that in SOME states it's actually illegal to "attempt" debt collections or "act" as a collection agency/service without a bond. That's why we have the "Mini Miranda". I'm actually amazed at all the physicians bills that do not include the Mini Miranda. CYA.
: Re: Polite / Nasty / Collections
: PMRNC August 05, 2013, 05:43:19 PM
I guess I have lucked out with our collections agency.  Once that percentage is added to the account and sent, they are awesome.  I dont really have a large number of accounts with them.  However, I can spend the entire day on the phone and get the runaround but the moment the agency contacts them, 95% of the time, they receive payment in full and we get our $$.  It's something about that 30 days the agency gives because they sure dont want it on their credit report (even though medical expenses is not suppose to  really "damage" your rating).   Another issue, if the patient sends the payment to us, we endorse it and send straight to the agency, because once they have it (the account), there is a fee and we are not paying for it, the person that owes will pay...

this brings me to a point to remind billers they absolutely MUST know the FDCPA. Once an account is sent to a bonded collection agency/service it becomes a legal matter under the collection agency/service bond. That means if a patient calls you on a bill sent to collections you must refer them to the collections company. If the patient even wants a bill, the request has to come from the collection agency. Almost like they become your legal counsel on that debt. Billers have to be aware of the FDCPA and their state collections practice laws because ONE slip up and your provider is OUT that money.  EVERY statement and coorespondence I send out to patients on behalf of my clients include the Mini Miranda. In states where I cannot even call a debtor it's noted in the patient's file.
: Re: Polite / Nasty / Collections
: rdmoore2003 August 05, 2013, 05:47:12 PM
absolutely, you would be surprised at those in this field that do not have any knowledge of this.
: Re: Polite / Nasty / Collections
: PMRNC August 05, 2013, 05:49:01 PM
I think I found a good article for next newsletter!
: Re: Polite / Nasty / Collections
: PMRNC August 05, 2013, 05:55:26 PM
How many billers would know about the  Pending bill H.R. 2211, the Accuracy in Reporting Medical Debt Act?

This will be a bill entitling consumers have ample time to resolve medical billing questions and potential errors before medical debt can be reported to the credit bureaus.

This would mean billers / physicians office billing staff, KNOW collection laws.
: Re: Polite / Nasty / Collections
: barb2512 October 14, 2013, 07:10:56 PM
I do billing for mental health providers in several states, Nevada, Texas, Maryland, Tennessee, Connecticut. Where can I learn about the collection agency laws so I can advise my client's?

Thank you,

Barbara
: Re: Polite / Nasty / Collections
: PMRNC October 15, 2013, 10:22:41 AM
I do billing for mental health providers in several states, Nevada, Texas, Maryland, Tennessee, Connecticut. Where can I learn about the collection agency laws so I can advise my client's?

You'll want to read up on the Fair Debt Collection Practices (Federal). In addition each state has their own collection rules. For example, your state may require the Mini Miranda in certain circumstances when doing patient billing.   You'll want to look at each state you have a client in as well as the state your billing from.
: Re: Polite / Nasty / Collections
: barb2512 October 15, 2013, 02:03:42 PM
Thank you. I will do that.

Barb :)