Patients unable to pay their entire outstanding balance aren’t a new phenomenon. Administrators try to minimize the likelihood of an unpaid balance by verifying the patient’s eligibility prior to the visit and by understanding the patient’s coverage for specific services and procedures. In this way, the manager can prepare the patient beforehand on the magnitude of his/her financial responsibility and obtain payment and/or some assurance of payment.
In the ideal world, the patient will pay the entire balance on the day of the service. However, we must distinguish between services that will be decided by the clinician at the time of the visit (which cannot be billed to the patient until the insurance company payment is received) and scheduled procedures with a known fee in advance. The organized practice will confirm the appointment with the patient and if the latter, stress that payment will be expected at the time of the visit.
If the patient cannot satisfy the entire balance, the administrator must make some decisions: postpone a non-urgent service until the patient can pay for it, or establish a payment plan. Payment plans are a courtesy system of allowing the patient to make payments on a balance; the two italicized words are intentional. At a minimum, your practice should have a written policy that covers all the aspects of a payment plan: who in the practice may establish one, any limitations on the size of balance that can be approved for payment plan, the average length of time of the plan and the payments involved (both how many installments and how those payments will be made).
Because many patients have credit cards, a credit card authorization form will allow the practice to charge each monthly payment directly to the card, although merchant fees will be deducted from the payment, so beware. Finally, your payment plan process should include a document – properly vetted by an attorney familiar with medical billing regulations – that spells everything out, including the ramifications of reneging on the plan.
Your office should monitor all the payment plans on a regular basis and keep good track of payments made or owed. Some practices have a tendency to forget about payment plans and attempt to catch up months after patients have been delinquent. If you treat a payment plan like any other account receivable, you will give it the attention it deserves and generally, collect the monies owed.
Many providers might find distasteful the process of firmly requiring payments, but a good office manager can tactfully and professionally establish and maintain the process of guarding your revenue. While flexibility and compassion can certainly factor into the payment plan process, you have a right to collect fair compensation for your medical care and services.