DEBRA MILLER | DIRECTOR OF COACHING
Payment is the last step in a patient’s endodontic journey into your practice. If the patient has a problem paying, discovering that fact at the moment they are leaving the practice is the worst time. At that point, you already have a collection problem because the patient balance will be added to your accounts receivable to collect later.
Collecting after the patient leaves is troublesome. No matter how much a patient promises to pay soon, inevitably a certain percentage of accounts don’t get paid promptly. That results in statements being sent and phone calls being made to prompt the patient to pay. When this happens too often, the accounts receivable keeps growing, and the administrative team must devote more and more time to chasing down overdue accounts.
If you end up sending accounts to a collection agency, that creates its own set of problems. Collection agencies can be very aggressive, and a patient (even though they haven’t paid their bill) may end up complaining about your collection methods to the referring GP. They will say they were not prepared for the cost of treatment and were financially blindsided in your practice. Plus, collection agencies charge a large fee for any amount they collect, so your net collections are reduced substantially.
Prevention is the cure
Like brushing and flossing to prevent dental problems, collection problems are best solved through prevention. In other words, the solution to patients not prepared to pay when they leave is to ensure they are prepared to pay before they arrive.
The patient phone call to schedule their appointment when they are first referred is the key. While there are many things that need to occur on this call, part of the call should be thought of as a financial consultation with the patient. This includes to:
- Ensure the patient is aware that even if they are being referred for a consult that treatment will proceed immediately at the same appointment if they are diagnosed.
- Collect insurance information from the patient to determine if they have coverage, what the insurance plan fee will be, and their expected copay.
- Give a clear estimate of their out-of-pocket costs due at the appointment (full fee for non-insured patients, copay for insured patients) and the methods of payment available.
- Ascertain if the patient has any concerns about their out-of-pocket costs and give them options such as third-party financing.
Due diligence on insurance
When the patient has insurance, determining their expected copay is essential. Often the administrator will need to collect the insurance information and then call the patient back after carefully estimating the copay in order to complete the financial consultation.
Estimating the copay means using the insurance company’s online tools (or contacting an insurance company rep if online tools aren’t available) to confirm the patient’s eligibility, remaining deductible, remaining benefits, and any other plan details that may affect the patient’s coverage. Realtime information is vital, especially when the patient is concurrently receiving treatment (and using up benefits) in the GP practice.
Administrative team organization
For a non-insured patient, the fee is known (your regular fee-for-service fee), and so the full financial consultation can occur on the first call. For an insured patient, almost always a second call will be required after the copay is estimated with the insurance company. This second call needs to occur as soon as possible after the first call.
Given that endodontic practices often have emergency patients appointed to come in later the same day, the administrative team needs to be organized and efficient. An administrator needs the time capacity to contact the insurance company immediately, estimate the copay, and call the patient back … within the hour sometimes! It’s the only way to ensure the patient arrives prepared for their costs.
Likewise, sometimes patients are appointed on a longer timeframe, and it’s important the administrative team updates the copay estimate close to the patient’s appointment date. In the weeks since the appointment was made, significant insurance benefits could have been claimed by the GP office.
Great admin teams carefully keep track of patient estimates, including when copays need to be determined and updated. By doing so, payment issues when the patient leaves can be significantly reduced, and the accounts receivable will go down.