Author Topic: What's the best way to collect from patients?  (Read 3431 times)

jcfenfen

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What's the best way to collect from patients?
« on: March 27, 2009, 11:12:55 PM »
I have couple patients have long overdue balances and they don't pick up the phone.  So what's the best way to collect from the patients? Which would work better, small claim court or collection agency? Any advice is greatly appreciated.   

Pay_My_Claims

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Re: What's the best way to collect from patients?
« Reply #1 on: March 28, 2009, 01:08:01 PM »
Unfortunately, the best way to collect is up front. Its so important for physicians to verify patient eligibility, ded, copay, and coins prior to office visits. Medical services like anything you get that can't be taken away is hard to collect for. You skip out on paying for a car, you can lose that and everything you paid into it, however, the MD can't get this dx back, nor his rx. You can just simply go to another physician.  The thought of going to collections can scare some people, but if you are REALLY worried about your credit, you would probably be paying the bill. Small claims court can be expensive, and it can only win you your case. Unless you are getting wage garnishments, you still won't collect. There is no right nor wrong way to go, and it all varies case by case. I would probably try sending out soft collections first, then a collection agency, then small claims. This is all depending on the amount of the debt. If its so low (copay) I would adjust off as a bad debt and place a note on the clients account. "BAD DEBT COLLECT OLD BALANCE*

jcfenfen

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Re: What's the best way to collect from patients?
« Reply #2 on: March 28, 2009, 01:18:51 PM »
Thank you so much for your great advice.  I am billing for hospitalist, so I can't collect up front when patient entered the hospital, only collect it afterwards, that's why it's problematic. 

Michele

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Re: What's the best way to collect from patients?
« Reply #3 on: March 30, 2009, 08:00:49 PM »
That is a difficult situation.  Pay_My_Claims had good advice.  I agree, soft collections (which you've really attempted), collection agency, small claims.

Michele
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Pay_My_Claims

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Re: What's the best way to collect from patients?
« Reply #4 on: March 31, 2009, 04:00:22 PM »
Thank you so much for your great advice.  I am billing for hospitalist, so I can't collect up front when patient entered the hospital, only collect it afterwards, that's why it's problematic. 

JC I feel your "pain". I know personally that polite bill collectors get the best response from me :-) I do soft collections now, and I'd prefer taking 4 months to pay a 100 bill than getting nothing at all. I know on your end the scale can be much higher.

PMRNC

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Re: What's the best way to collect from patients?
« Reply #5 on: April 04, 2009, 12:59:43 PM »
I am insured through a PPO Plan and we have $35 ER Copay with participating hospitals, I have noticed over past couple of years the intake dept wants the copay up front. The last time I went to the ER with my daughter I had overheard a woman say the hospital required her to pay her 20% up front.. I didn't want to infringe on her privacy but if that was me I would have asked hospital how I would be expected to pay 20% of charges that were not rendered or known! I can understand co-pay's, but not coinsurance.

I feel for you also, I would not want to work collections in any capacity for a hospital!!  :o

Linda Walker
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ajgallag

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Re: What's the best way to collect from patients?
« Reply #6 on: May 15, 2009, 09:56:34 PM »
How does a patient handle a situation where the provider has billed incorrectly and gets a denied claim because the ID number is wrong?
If the patient makes a reasonable effort to contact the biller and supply the correct id number, can the patient be held accountable and turned over to collections?
The insurance company says they can help with almost anything but cannot submit a claim for the provider.  Is the insurance company responsible to call the provider for the patient and help with this type of denial? 
I wonder how many other people are getting letters threatening collection for these types of situations.
Andy

Michele

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Re: What's the best way to collect from patients?
« Reply #7 on: May 16, 2009, 05:38:39 AM »
The patient is responsible to provide the dr with the correct insurance information in order for their insurance to be billed.  If that information is provided in a timely manner and the provider is in network with the patient's insurance company, then it is the provider's responsibility to get the claim in and processed. 

If I were the patient, I would make sure I not only provided them with the correct info, but actually gave them a copy of my ID card.  If I suspected a problem then I would contact the billing office and ask why they are not submitting my claim with the correct insurance info.  I would document all of my actions, when I gave them the insurance info, whenever I called the office, whenever I called the insurance carrier.  If the insurance carrier is indicating that they don't have the claim, or don't have it correctly, I would call the office again and advise them what the insurance carrier told me.  Ultimately if the patient does all possible and has it documented, and the provider is in network, the patient will not be help liable.  If the provider tries to bill the patient, the insurance carrier can terminate them from participation. 

Good luck
Michele
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PMRNC

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Re: What's the best way to collect from patients?
« Reply #8 on: May 16, 2009, 08:45:00 AM »
 ???  But wait. If the claim was denied for incorrect ID #.. patient called, corrected it, the claim should have been processed.
Unless it was denied for something else I don't see what it matters who made the error, the claim should have been processed once the patient gave the carrier the correct ID #.
Linda Walker
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Michele

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Re: What's the best way to collect from patients?
« Reply #9 on: May 16, 2009, 03:58:03 PM »
I wish it was that easy with the carriers we deal with.  When most of our major carriers, BCBS, etc, receive claims with incorrect ID#'s they reject them electronically and no claim is ever in their processing system, so they can't just reprocess.  They require that we resubmit with the correct ID.  Sounds like this poor patient can't get the billing dept to just submit a claim with their info all accurate.  Doesn't seem like they should be having such a hard time does it?  We love when patient's call us with the correct info and we don't have to track them down! 

Michele
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ajgallag

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Re: What's the best way to collect from patients?
« Reply #10 on: May 16, 2009, 04:53:07 PM »
Thank you.  After three phone calls they still had the ID incorrectly.  I think I will mail a photocopy.  They did call friday and verify that I had coverage and submit the claim electronically. I will check the website periodically to see if the claim is there.

The first bill has a comment stating insurance denied.  I called and inquired about the bill and the id number had to be corrected.  The second bill did not reflect whether insurance was pending so I assumed we were still waiting on an insurance response.  The third bill stated pre-collections notice and stated that I have 15 days to make final payment.  They have not adequately answered my questions and I am concerned that this account will pass in to collections at the end of 15 days.
What a headache.

I find it hard to believe that they do not have the capability to reflect an accurate status on my bill.  Are there separate "pools" for cash versus insurance?  Does the account need to be updated from a cash basis to prevent it from going to collections?

Yes, Michelle, some companies send claims back.  My insurance was awesome for a year.  Then one of the big companies purchased them.  I have had numerous surprise bills from providers who got denied.  There is no EOB and when I call of course no h istory because the claim got returned.
I have spent the last 6 months trying to make sure all these bills get submitted.  I was advised by the insurance that I cannot be billed by the provider but it makes me uneasy.  So keep on your toes and make sure you have original dates for proof of submission!

And yes, I would think they would be happy to have a helpful patient.  They ignored me when I gave them the phone number (with extension) provided by the carrier.  I guess maybe the buyout is creating problems.


Thanks,
Andy
 

dfranklin

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Re: What's the best way to collect from patients?
« Reply #11 on: June 10, 2009, 12:03:12 AM »
I have a great alternative to the Traditional collection Agency that I set up for doctors/billers (and any other business that is owed money for that matter).  It is web based ( so you can submit from anywhere and can be checked on 24 hours a day), fees for as little as 5%, includes a retained attorney (sends letters, makes phone calls and litigates if necessary), credit reporting and has a 42% recovery rate.  Each account is systematically worked and is not cherry picked as traditional collection agencies do and you can check the statuses of them whenever you want.  You stay in control not the collection agency.  An overall better way to collect past due accounts.

You can read more about it on my website at:http://www.rxbizsolutions.com/ser_prs.php or feel free to email me if you have any questions or if you would like to set up the service. Email:dfranklin@rxbizsolutions.com.

Tlaughlin

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Re: What's the best way to collect from patients?
« Reply #12 on: June 10, 2009, 03:21:55 PM »
Collect up front is always the best but we are not always able to do that. Our policy is if no payment received in 60 days, the patient gets a letter from us stating their account is going to a collection agency if no response within 30 days and without further notice. We mail the letter certified with a fee for the letter to cover the cost. If no payment or arrangements are made, it goes to collections. Be sure and get a good collection agency that will work with you and go to court for you.

Steve Verno CMBS, CEMCS

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Re: What's the best way to collect from patients?
« Reply #13 on: August 12, 2009, 09:48:44 PM »
An ER practice billing company I worked for developed a simple program for the doctors to use.  The patient came to the ER and just before discharge, the doctor went to the nurses station where we set up a computer and printer and the program.  The doctor logged in the patient basic info as well as answered some simple questions.  When done, the doctor printed three CPT coded statements.  The doctor walked the uninsured patient to the cashier, handed the patient one of the statements and said, here is where you pay my bill.  The program was tested over and over again for any possible coding errors.  It was always 100% accurate.  Doing this increased practice revenue by $200,000 the first year it was done.  Most patients paid, some didnt, and no one ever  complained about not getting a bill.  The software was put in all of the hospitals where our providers worked.  Some providers said they didnt like giving the patient a bill.  That issue was left to the practice.  We never forced the provider to use the progam and the provider never argued about the bill with the patient.  Strange was not one patient complained about being handed a bill by the doctor.  If the patient said they couldnt pay, no problem, we contacted them to work out financial hardship. 

When I grew up and went to the hospital, no one got out the door without going through the cashiers office.  The same in the military hospitals where my wife or son were admitted.  When we moved to Florida, we found a nice, small family practice clinic in a converted house.  The provider was also retired military.  He had a secretay that was probably Washington's secetary.  There were no computers.  She filed everything in a manila folder.  When you walked in, she knew you by name, as well as asking about your spouse and children by name.  She did all claims on an old IBM Selectric.  When you were done, the provider asked you for your out of pocket expenses.  The seretary was on the phone to your insurance to verify everything, She also knew how much your insurance allowed and paid.  We didnt mind paying the provider and we also knew we had to pay what we were supposed to pay.  We never got any statement because he saved money by collecting at the time of service  No need to send a statement.  We liked him until he retired from medicine .  after that we had to use the emergency room because no doctor in my area accepted my insurance.  We upgraded to the local urgent care center.  all bills eceived that wer correct were paid. Incorrectly coded visits were disputed and when corrected, paid. 
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