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Growth Strategies: Adding Cash Services<
by: Judy Capko
Cash services return to medical practices A larger percentage of patients are paying for a greater portion of their medical expenses. Employers' health plans are requiring larger deductibles from patients, and patients are increasingly held financially responsible for their medical care. We seem to be headed back in time to when physicians' staff matter-of-factly collected payment at the time of service. When you add to this new fiscal terrain the fact that some practices are introducing cash services to pump up revenue, it is clear that the medical services landscape is indeed morphing into a blend of the old and the new. This shift "back to the future" can be anything but seamless. In more recent years, practice staff have traditionally collected small copays from patients and left the rest to the billing department. These staff may have more than a little difficulty now asking patients for larger payments. Collecting more at the time of service requires a change of mindset. Your practice must adopt and enforce a firm financial policy reinforced by staff training on over-the-counter collections. Where to start? Begin by reviewing your existing financial policy. Develop a patient payment policy that addresses large deductibles, copays, payment on patient balances, and collection for cash-only services. Clearly communicate to your patient base your expectations for payment, including when exceptions are permissible. For example, if there is a $600 existing patient balance, do you expect the patient to pay the entire amount when he next visits the office, or will you accept two equal payments of $300 — one over the counter and the next within 30 days? How will you communicate your expectations to your patients, and how will you handle hardship cases? Although physicians play an integral role in developing their practice's financial policy, Judy Pickering, office manager for a primary-care medical group in California, says, "Finances work best when the doctors have staff they can turn the collection process over to without the need to interfere." Regardless of which policies and procedures you enact, you must establish an effective method for educating your staff and patients about the new rules. At minimum, any new policies should be orally presented to staff, appear in your billing handbook, be added to your employee training manual, and be placed on both your Web site and in a clearly visible spot at your practice's front desk. You can further support your expectations by placing a notification of payment policy on your patients' monthly statements. The consistency with which your staff communicates and applies your policies will play a vital role in your success. For staff unaccustomed to asking patients for money, provide a training session supported with practice scripts and role-playing. Staff members must be comfortable asking patients for payment, and it's your responsibility to teach them to do so and then hold them accountable. FOLLOW THE EXPERIENCED You can learn a lot from practices that already provide "cash services" to their patients. "Good communication is the key," says Linda Minkel, administrator for Pacifica Institute of Cosmetic and Reconstructive Surgery in Camarillo, Calif. "We query our patients when they first call in to determine whether their needs are cosmetic or reconstructive. Following the consultation, cosmetic patients are given a written estimate of fees for the elective procedure that is being considered. These fees must be paid prior to the surgery. If it's a matter of insurance, we do the pre-authorization following the consultation. Once we obtain authorization, the patient is called to schedule the pre-op appointment. At that time, we let her know what is covered by insurance and what her financial obligation< |
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