Author Topic: Irate or difficult client  (Read 1025 times)

Michele

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Irate or difficult client
« on: October 26, 2021, 10:03:13 AM »
I received this question as a personal message and am posting it public:

What advices or suggestions can you provide when a medical biller/coder encounters an irate client, a client does not want to pay you for your services, and/or the client wants you to engage into billing fraud?
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Michele

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Re: Irate or difficult client
« Reply #1 on: October 26, 2021, 10:13:12 AM »
If a provider is doing anything that we are concerned may be fraudulent we have a conversation with them about the situation.  They may not realize that the activity is fraudulent, or we may misunderstand what's happening.  If after having that conversation we are uncomfortable, or believe it is fraudulent we notify them that we cannot do what they are requesting and we terminate our services.  Our contract allows for termination due to fraud. 

As for irate clients, we try to do whatever we can to correct the situation making them irate.  If we did something wrong, we fix it.  If they are irate due to a situation we can't fix that is not our fault, or out of our control we explain why things are happening that way.  Usually this calms the provider down, unless they are irrational.  We have had one or two of those in 27 years, but most providers understand.  As long as you are doing your job, and making sure that what is in your control is happening as it's supposed to be, things are usually good.  If it's something out of our control we do try to research if there is anything that can be done on the provider's behalf.  For example, if an insurance carrier is not paying when they should have, we might file a complaint with the insurance commissioner on the provider's behalf.

For client's that do not want to pay, we first figure out why they don't want to pay.  Are they upset about something?  Is it something we can rectify?  If they just don't want to pay, but nothing is wrong, we stop providing services and then pursue collections of the money owed to us.  Our contract covers this situation as well.
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kristin

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Re: Irate or difficult client
« Reply #2 on: October 30, 2021, 03:44:47 AM »
What advices or suggestions can you provide when a medical biller/coder encounters an irate client, a client does not want to pay you for your services, and/or the client wants you to engage into billing fraud?

My two cents:

1. Irate client: In my experience, clients are usually irate about two things...lack of receivables, and what they are charged for our services.

When it comes to lack of receivables, I find that this happens right around February/March every year. Which is when I have to once AGAIN explain to the clients that we are meeting Medicare/commercial insurance deductibles, and there is nothing we can do to change that. And I have to explain it every single year to the same clients. They are happy all year, except during those months.

When it comes to what we charge them, they often hear from another provider they know that that provider is being charged a lesser rate by their billing company, and why don't they have the same rate? And I have to explain what all it is that our company does, and does their friend's billing company do the same work? And it never is the same. Not by a long shot.

Here is something providers will NEVER understand about having a billing company versus an in-house biller:
Regardless of what the billing company charges, be it a percentage or a flat rate, they will always pay less to have a billing company versus an in-house biller, unless they are dealing with a billing company that has outrageous fees. The providers don't take into account so many factors when the biller is in-house versus having a billing company. Like payroll taxes, for example. The list goes on, and on.

2. A client does not want to pay for your services: This comes down to the contract you have with the client. What Michele said is spot on.

3. Client wants you to engage in billing fraud: There are two types of billing fraud. The type where the client doesn't understand what they are doing is fraud, "they are ignorant", and the type where they do understand, and just won't listen to why it is fraud. For the second type, drop them immediately as a client. For the first type, attempt to educate them. If they won't listen, drop them as a client.






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Re: Irate or difficult client
« Reply #2 on: October 30, 2021, 03:44:47 AM »