Medical practices use multiple methods to inform patients of their financial policies and procedures. Payment policies are explained in brochures and on signs in the reception area as well as orally by registration staff. Patients are often asked to read and sign a statement that they understand and will comply with the payment policy.
Updated patient ledgers reflecting all charges, adjustments, and previous payments to patients’ accounts are used to generate patient statements, printed bills that show the amount each patient owes. Patients may owe coinsurance, deductibles, and fees for noncovered services. The statements are mailed according to the billing cycle that is followed. They are designed to be direct and easy to read, clearly stating the services provided, balances owed, due dates, and accepted methods of payment.
Under individual patient billing, each patient who has a balance receives a mailed patient statement. Under guarantor billing, statements are grouped by guarantor and cover all patient accounts that are guaranteed by that individual. Guarantor billing produces fewer bills to track but can become unwieldy when family members have various health plans and/or secondary payers.
The process of bill collecting in the medical office is usually governed by set policies and overseen by a manager. Several employees may assist in this part of the business, including managers, bookkeepers, and collections specialists. Managers are responsible for establishing office policies and enabling collections specialists to successfully perform their jobs. Bookkeepers record funds coming into and going out of the practice. Collections specialists study aging reports and follow up on patient accounts that are due.
Efforts to collect past-due patient balances are strictly regulated by law and by office policy. Both collection letters and phone calls are integral parts of the collections process. Collections specialists maintain a professional attitude while being straightforward. They must be prepared for difficult situations and ready to work out credit arrangements and payment plans.
When patients have not met their financial obligations and collection activities need to be assigned to an agency for further efforts, practices use collection agencies. The practice chooses an agency that best fits its needs. Credit reporting can be a valuable collection tool and is enforced on debtors who have not paid their bills.
When patients cannot be reached or do not respond to letters and phone calls, it often becomes necessary to skip trace. There are several inexpensive ways to locate a missing patient, and specialized agencies or electronic databases are effective methods at a cost. Phone calls to possible contacts must be handled carefully.
Not all balances due to the practice will be paid. Patients sometimes die, file for bankruptcy, are unable to pay their bills, or cannot be traced. Knowing when to write off an account is important, and using caution when doing so to avoid possible fraud is a top priority. Likewise, it is important to pay a refund if a patient has been overcharged.
The retention of medical records follows office policy and is also regulated by law. Retention schedules are followed to ensure records will be available for proper patient care. Medical practices must be ready to answer patient requests for information and records and to defend any claims that are questioned.
