Re: oops

[Guest guest]

Dunno but I sure you'll be able to tell us soon. *wink*

- Edith

sexystarshine79@... wrote:

> My one year old just hit the spam button for a e mail from someone in the

> group. will I still be able to get group mail?

[Guest guest]

Dunno but I sure you'll be able to tell us soon. *wink*

- Edith

sexystarshine79@... wrote:

> My one year old just hit the spam button for a e mail from someone in the

> group. will I still be able to get group mail?

[Guest guest]

Dunno but I sure you'll be able to tell us soon. *wink*

- Edith

sexystarshine79@... wrote:

> My one year old just hit the spam button for a e mail from someone in the

> group. will I still be able to get group mail?

[Guest guest]

Sangeetha,Welcome to the listserve. I don't think you can have it both ways:1. No third party interfering between you and the patient AND2. No direct payment from the patient to you.Yeah, it makes me uncomfortable asking for money, but I do it because it reinforces the concept that YOU are providing the service and the patient is paying YOU. You can put an employee between you and the patient just to collect the "filthy lucre" but that's still a third party and you are already questioning the reliability of such a person. Is it worth the extra cost just so you don't have to touch the money?Money is not a bad thing. Really. You are not treating patients out of the goodness of your heart (at least I don't think you are) and your patients should know this. No margin = no mission. I think this is one reason why doctors allowed ourselves to get into this whole 3rd party insurance mess. We didn't want to get involved with the money. Well, see how well that has turned out? Let's do a head count. How many physicians here ever actually ask for or collect money from your patients? I do. SetoSouth Pasadena, CAI think the first message took off..Anyhow, hello everyone I am new here. I will be moving my practice toa low overhead model (I cannot call it IMP yet- I will not give cellphone acess). I will have a staffer , less space, less telecomexpenditure than my current expense sharing setup. My question is -the part of accepting payments really gets in the way of the patientphysician relationship. In the absence of a staffer what do you guysdo> Bill pay, preprinted invoices, autocheckin kiosks?I expect to take my time to find the right person ( ya right!), willhave to account for absences and sickness and want to set up a smoothworkflow for copay collection that doesnt involve the patient seeingme as collecting the money.Thanks SM

[Guest guest]

head count #2 . yes. of course butI do have a biller and I like that I can share talking with patietns with bill problems with her She is very sweet and often fixes things and the team work with her is very nice

It takes some gettin g used to to ask for money Sometimespatietns just don;t understand truly The card says right on it 15.00 office vsit and tehy might not know. Alway s good to defer to Them " yep that;s what They say right here " I say

I mean I do not make theri isiruance rulesTo my mediciad patietns I say things a bit differnlty They have a 3.oo copay but while I desperalty want it they do not have any money these folks One guy was going to walk to see me yesterady 10 miles but he got his dad's care as long as he picked dad up at the mill at 4 am.

For th em I say " Can you do your 3.00 copay? " They say can I pay next time, about 3/4 of the itme Sometimes i have given THEM money like for gas.One I bought some one;s meds for them - they paid me back later

It is always good for you, a family doc ,to have like, a wife with a good job in town ( alsaka homestaeders phrase) if you want money But you will get used to asking and you will find your own way to do it

welcome

Sangeetha,Welcome to the listserve. I don't think you can have it both ways:1. No third party interfering between you and the patient AND2. No direct payment from the patient to you.

Yeah, it makes me uncomfortable asking for money, but I do it because it reinforces the concept that YOU are providing the service and the patient is paying YOU. You can put an employee between you and the patient just to collect the " filthy lucre " but that's still a third party and you are already questioning the reliability of such a person. Is it worth the extra cost just so you don't have to touch the money?

Money is not a bad thing. Really. You are not treating patients out of the goodness of your heart (at least I don't think you are) and your patients should know this. No margin = no mission. I think this is one reason why doctors allowed ourselves to get into this whole 3rd party insurance mess. We didn't want to get involved with the money. Well, see how well that has turned out?

Let's do a head count. How many physicians here ever actually ask for or collect money from your patients? I do. SetoSouth Pasadena, CA

I think the first message took off..Anyhow, hello everyone I am new here. I will be moving my practice to

a low overhead model (I cannot call it IMP yet- I will not give cellphone acess). I will have a staffer , less space, less telecomexpenditure than my current expense sharing setup. My question is -the part of accepting payments really gets in the way of the patient

physician relationship. In the absence of a staffer what do you guysdo> Bill pay, preprinted invoices, autocheckin kiosks?I expect to take my time to find the right person ( ya right!), willhave to account for absences and sickness and want to set up a smooth

workflow for copay collection that doesnt involve the patient seeingme as collecting the money.Thanks SM

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

head count #3

I was dreading this. Now after 6 weeks it's not hard.

I've had patients walk and drive back to hand me co-pays I forgot.

They don't mind when they feel they've got my full attention and can reach me any time.

Don't be afraid of giving out the cell phone. Read previous posts.Regardless, it's not the cell phone that makes or breaks the idea that you are an IMP.

Unfrettered access and suberb care that makes both the patient and the doctor happy is what makes an IMP. See Ideal Medical Practice FAQ at http://idealmicropractices.wikia.com/wiki/Ideal_Micropractice_FAQ

Welcom.

I think the first message took off..Anyhow, hello everyone I am new here. I will be moving my practice toa low overhead model (I cannot call it IMP yet- I will not give cellphone acess). I will have a staffer , less space, less telecomexpenditure than my current expense sharing setup. My question is -the part of accepting payments really gets in the way of the patientphysician relationship. In the absence of a staffer what do you guysdo> Bill pay, preprinted invoices, autocheckin kiosks?I expect to take my time to find the right person ( ya right!), willhave to account for absences and sickness and want to set up a smoothworkflow for copay collection that doesnt involve the patient seeingme as collecting the money.Thanks SM-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

[Guest guest]

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation.

" He is no fool who gives what he cannot keep to gain what he cannot lose "

[Guest guest]

started his reply with "How many of us collect our own monies?" followed up with "head count #2" and I was #3.

Subject: Re: oopsTo: @...Date: Saturday, August 30, 2008, 7:12 PM

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation."He is no fool who gives what he cannot keep to gain what he cannot lose"

[Guest guest]

Reply #4

and I collect our own copays and AR. We write off <3% per year. We send statments every 7th of the month asking people who owe > 90 days to pay immediately. Everyone else has till the 28th to pay. We send statements once a month and each time an EOB is posted to patients invoice with payment or not. By three bills our EMR flags with message on statement your bill is past due please call today. We call each of these and write hand written notes. If unpaid on July 1st we write it off and note in chart and bill. We repeat at end of year.

From: Rene Milner <rlmilnergmail (DOT) com>Subject: Re: [Practiceimprovemen t1] oopsTo: Practiceimprovement 1yahoogroups (DOT) .comDate: Saturday, August 30, 2008, 7:12 PM

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation."He is no fool who gives what he cannot keep to gain what he cannot lose"

[Guest guest]

Me Four. I collect copays when checking people in; I call when a claim is denied by insurance to ask the patient AGAIN if they have changed insurance or to tell them about the denial and invite them to challenge their insurance themselves; If someone with a balance calls for an appointment I say: " you know you have an $83 balance that you'll have to bring with you when you come in. " ; and I send personal letters to the over 90 day aging before I turn them over for collections. I used to be bothered by this, but not any more. The phone guy won't walk into the building without I hand him $100 cash....I gotta get paid too.

Annie

started his reply with " How many of us collect our own monies? " followed up with " head count #2 " and I was #3.

Subject: Re: oops

To: @...Date: Saturday, August 30, 2008, 7:12 PM

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation.

" He is no fool who gives what he cannot keep to gain what he cannot lose "

-- Annie SkaggsLexington, KY

[Guest guest]

#5I'm solo, I have a cash practice, so I handle the payments. I don't mind asking people at the end of the visit for payment. In order for them to continue getting the excellent care to which they are growing accustomed, I have to stay in business. That means I have to get paid. Most people seem to understand this and most people seem to feel that they are getting a good value for their money. I do have a few who seem to not be real happy with the arrangement, but I just figure you can't please everyone no matter what. After a little over a year in practice I have one patient who "forgot" her checkbook and still (2 months later) hasn't sent me a check despite an email, a phone call and a letter. I'll contact her again in a month and tell her she needs to find another physician unless she contacts me to make some

sort of arrangement.

From: Rene Milner <rlmilnergmail (DOT) com>Subject: Re: [Practiceimprovemen t1] oopsTo: Practiceimprovement 1yahoogroups (DOT) .comDate: Saturday, August 30, 2008, 7:12 PM

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation."He is no fool who gives what he cannot keep to gain what he cannot

lose"

[Guest guest]

I collect the money from my patients. At

the end of the visit, I ask, ‘So how do you want to take care of today;

cash, check or charge?’ It gets easier after you’ve done it a

few times.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

www.PinnacleFamilyMedicine.com

From: [mailto: ] On Behalf Of Seto

Sent: Saturday, August 30, 2008

4:37 PM

To:

Subject: Re:

oops

Sangeetha,

Welcome to the listserve. I don't think you can have it both ways:

1. No third party interfering between you and the patient AND

2. No direct payment from the patient to you.

Yeah, it makes me uncomfortable asking for money, but I do it because

it reinforces the concept that YOU are providing the service and the patient is

paying YOU. You can put an employee between you and the patient just to collect

the " filthy lucre " but that's still a third party and you are already

questioning the reliability of such a person. Is it worth the extra cost just

so you don't have to touch the money?

Money is not a bad thing. Really. You are not treating patients out of

the goodness of your heart (at least I don't think you are) and your patients

should know this. No margin = no mission. I think this is one reason why

doctors allowed ourselves to get into this whole 3rd party insurance mess. We

didn't want to get involved with the money. Well, see how well that has

turned out?

Let's do a head count. How many physicians here ever actually ask for

or collect money from your patients? I do.

Seto

South Pasadena,

CA

I

think the first message took off..

Anyhow, hello everyone I am new here. I will be moving my practice to

a low overhead model (I cannot call it IMP yet- I will not give cell

phone acess). I will have a staffer , less space, less telecom

expenditure than my current expense sharing setup. My question is -

the part of accepting payments really gets in the way of the patient

physician relationship. In the absence of a staffer what do you guys

do> Bill pay, preprinted invoices, autocheckin kiosks?

I expect to take my time to find the right person ( ya right!), will

have to account for absences and sickness and want to set up a smooth

workflow for copay collection that doesnt involve the patient seeing

me as collecting the money.

Thanks

SM

[Guest guest]

I do what Annie does. It really does get easier with time. Just this week though, I got a call from someone who owes more than $200. ( 3 visits without insurance, without telling me about the first 2, last one was an "l'll gladly pay you Tuesday for a pap smear today") She was really sick with a terrible headache she was sure was meningitis. I said "you need to go to the ER", she said, "I don't have insurance", I said "you have a big balance here too and I can't take care of meningitis." She didn't come in, went to er, her Mom called me and gave me grief too on the voicemail, she said "I can give you $50, if that's what it takes". This patient is 28 yrs old. They are not destitute. I didn't call her back. I had sent the patient the listing for all the free care you can get here in Columbus.

Then later this week the Mom came in and told me how it was a good thing she went in because she had a ct scan done that showed she had swollen muscles all in her neck and head. (WoW, that does sound painful) and the ER doctor just didn't even know what would happen if she hadn't gotten some flexeril and oxycodone. She might have gotten, and I quote, " a severe stick neff". (I think the diagnosis was probably stiFF neCK)

Anyway, guess what, still no payment. My assistant and I both tell people that some sort of effort needs to be made. Some people send just $5 a month and I'll keep seeing them. When it gets hard is when you have entire families who will be pissed off. I don't mind losing a patient here and there (especially when you are seeing them for free).

KrisIt's only a deal if it's where you want to go. Find your travel deal here.

[Guest guest]

I send bills the day the insurance payment comes in, although I usually just

charge their credit card. If I do not have a card, I send the statement. I then

send another one that demands payment in 15 days, usually within a month. Write

off very little < 1% of collectables. Why wait 30 days? Since I do my own

billing, it also spreads out the statements and the cash flow. Hard to do all in

one day.

Have a patient from Ar, who currently owes me $1000 for reconstructing his kid's

face after a bike accident here-insurance approved amount. I am thinking of

small claims court.

________________________________

From: on behalf of Egly

Sent: Sat 8/30/2008 6:22 PM

To:

Subject: Re: oops

Reply #4

and I collect our own copays and AR. We write off <3% per year. We send

statments every 7th of the month asking people who owe > 90 days to pay

immediately. Everyone else has till the 28th to pay. We send statements once a

month and each time an EOB is posted to patients invoice with payment or not. By

three bills our EMR flags with message on statement your bill is past due please

call today. We call each of these and write hand written notes. If unpaid on

July 1st we write it off and note in chart and bill. We repeat at end of year.

From: Rene Milner <rlmilnergmail (DOT) com>

Subject: Re: [Practiceimprovemen t1] oops

To: Practiceimprovement 1yahoogroups (DOT) .com

Date: Saturday, August 30, 2008, 7:12 PM

Head count #3?

I often collect copays but I we have a problem with outstanding bills. I too

find it hard to address the issue of outstanding debt with patients.

Rene

NOTICE: This email (including attachments) is covered by the Electronic

Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be

legally privileged. If you are not the intended recipient, you are hereby

notified that any retention, dissemination, distribution, or copying of this

communication is strictly prohibited. If you have received this communication in

error, please immediately notify the sender by email or by telephone at 1(715)

557-0185 and DELETE the original message from your system. Thank you for your

cooperation.

" He is no fool who gives what he cannot keep to gain what he cannot lose "

[Guest guest]

Already responded, but I guess that makes me #5

________________________________

From: on behalf of Myria

Sent: Sat 8/30/2008 5:33 PM

To:

Subject: Re: oops

started his reply with " How many of us collect our own monies? " Jean

followed up with " head count #2 " and I was #3.

Subject: Re: oops

To: @...

Date: Saturday, August 30, 2008, 7:12 PM

Head count #3?

I often collect copays but I we have a problem with outstanding bills. I too

find it hard to address the issue of outstanding debt with patients.

Rene

NOTICE: This email (including attachments) is covered by the Electronic

Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be

legally privileged. If you are not the intended recipient, you are hereby

notified that any retention, dissemination, distribution, or copying of this

communication is strictly prohibited. If you have received this communication in

error, please immediately notify the sender by email or by telephone at 1(715)

557-0185 and DELETE the original message from your system. Thank you for your

cooperation.

" He is no fool who gives what he cannot keep to gain what he cannot lose "

[Guest guest]

I have been in Family Medicine for the past 28 years and have always

collected my fees directly from the patient, including my Medicare

patients. I've found this to be a viable, gratifying and successful way

to practice. I agree with that to delegate the collection of

monies to a third party is wrought with the kind of problems we find

ourselves with the insurance companies. I feel terrible for my

colleagues when I hear about their struggles and frustrations in trying

to be the kind of doctor we were trained to be and not be able to

practice as we were trained because of the insurance hurdles and

hassles. We should ultimately answer only to our patients, no other

third party with their own self interests.

Stanley Frochtzwajg, M.D.

Ventura, CA

>

> > I think the first message took off..

> >

> > Anyhow, hello everyone I am new here. I will be moving my practice

to

> > a low overhead model (I cannot call it IMP yet- I will not give cell

> > phone acess). I will have a staffer , less space, less telecom

> > expenditure than my current expense sharing setup. My question is -

> > the part of accepting payments really gets in the way of the patient

> > physician relationship. In the absence of a staffer what do you guys

> > do> Bill pay, preprinted invoices, autocheckin kiosks?

> >

> > I expect to take my time to find the right person ( ya right!), will

> > have to account for absences and sickness and want to set up a

smooth

> > workflow for copay collection that doesnt involve the patient seeing

> > me as collecting the money.

> >

> > Thanks

> >

> > SM

> >

> >

> >

>

[Guest guest]

Hello,

Thank you for all your responses.

I have ABSOLUTELY no problem asking for payment for the full visit

charge , delinquent bills etc. In fact, fairly routinely discharge

patients and send them to collections if they have balances/ no

mitigating circumstances even in my current set up.

Its the $5 copays that I have a problem with. That requires a little

resetting of expectations.And I appreciate 's input.That has

ceratinly stiffened my spine!I am really looking for a GTD kind of

solution that requires little human interaction, and so no quibbles on

anybody's part.

1.PAYpal ebills?,

2.keeping card on file

(esp for hmo patients who have signed up to see you and you alone on a

consistent basis. yeah , I have a a few hmo patients which I seem to

have figured out how to manage, not yet onerous, with online referrals

etc etc),

3.not collecting at time of service and having external billers bill?-

since they get percentage of collections anyway.

(I do not do my own billing-tended to want to chase every penny - when

I last did that -for 2 yrs)

Any thoughts and any ecperiences with that.

Thanks again everybody

Sangeetha

[Guest guest]

Ok, even though Im not a physician, I'll answer for ours. No.

Thats because I do instead. But I am her brother...

Re: oops

Sangeetha,

Welcome to the listserve. I don't think you can have it both ways:

1. No third party interfering between you and the patient AND

2. No direct payment from the patient to you.

Yeah, it makes me uncomfortable asking for money, but I do it because it reinforces the concept that YOU are providing the service and the patient is paying YOU. You can put an employee between you and the patient just to collect the "filthy lucre" but that's still a third party and you are already questioning the reliability of such a person. Is it worth the extra cost just so you don't have to touch the money?

Money is not a bad thing. Really. You are not treating patients out of the goodness of your heart (at least I don't think you are) and your patients should know this. No margin = no mission. I think this is one reason why doctors allowed ourselves to get into this whole 3rd party insurance mess. We didn't want to get involved with the money. Well, see how well that has turned out?

Let's do a head count. How many physicians here ever actually ask for or collect money from your patients? I do.

Seto

South Pasadena, CA

I think the first message took off..Anyhow, hello everyone I am new here. I will be moving my practice toa low overhead model (I cannot call it IMP yet- I will not give cellphone acess). I will have a staffer , less space, less telecomexpenditure than my current expense sharing setup. My question is -the part of accepting payments really gets in the way of the patientphysician relationship. In the absence of a staffer what do you guysdo> Bill pay, preprinted invoices, autocheckin kiosks?I expect to take my time to find the right person ( ya right!), willhave to account for absences and sickness and want to set up a smoothworkflow for copay collection that doesnt involve the patient seeingme as collecting the money.Thanks SM

[Guest guest]

What's tougher is when the patient's say "I don't think I should have to pay the copay on this visit because <insert reason here>"

Re: oops

head count #2 . yes. of course butI do have a biller and I like that I can share talking with patietns with bill problems with her She is very sweet and often fixes things and the team work with her is very nice It takes some gettin g used to to ask for money Sometimespatietns just don;t understand truly The card says right on it 15.00 office vsit and tehy might not know. Alway s good to defer to Them "yep that;s what They say right here" I say I mean I do not make theri isiruance rulesTo my mediciad patietns I say things a bit differnlty They have a 3.oo copay but while I desperalty want it they do not have any money these folks One guy was going to walk to see me yesterady 10 miles but he got his dad's care as long as he picked dad up at the mill at 4 am.For th em I say " Can you do your 3.00

copay?"They say can I pay next time, about 3/4 of the itme Sometimes i have given THEM money like for gas.One I bought some one;s meds for them - they paid me back later It is always good for you, a family doc ,to have like, a wife with a good job in town ( alsaka homestaeders phrase) if you want money But you will get used to asking and you will find your own way to do itwelcome

Sangeetha,

Welcome to the listserve. I don't think you can have it both ways:

1. No third party interfering between you and the patient AND

2. No direct payment from the patient to you.

Yeah, it makes me uncomfortable asking for money, but I do it because it reinforces the concept that YOU are providing the service and the patient is paying YOU. You can put an employee between you and the patient just to collect the "filthy lucre" but that's still a third party and you are already questioning the reliability of such a person. Is it worth the extra cost just so you don't have to touch the money?

Money is not a bad thing. Really. You are not treating patients out of the goodness of your heart (at least I don't think you are) and your patients should know this. No margin = no mission. I think this is one reason why doctors allowed ourselves to get into this whole 3rd party insurance mess. We didn't want to get involved with the money. Well, see how well that has turned out?

Let's do a head count. How many physicians here ever actually ask for or collect money from your patients? I do.

Seto

South Pasadena, CA

I think the first message took off..Anyhow, hello everyone I am new here. I will be moving my practice toa low overhead model (I cannot call it IMP yet- I will not give cellphone acess). I will have a staffer , less space, less telecomexpenditure than my current expense sharing setup. My question is -the part of accepting payments really gets in the way of the patientphysician relationship. In the absence of a staffer what do you guysdo> Bill pay, preprinted invoices, autocheckin kiosks?I expect to take my time to find the right person ( ya right!), willhave to account for absences and sickness and want to set up a smoothworkflow for copay collection that doesnt involve the patient seeingme as collecting the money.Thanks SM-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

[Guest guest]

That's the spirit Annie!

Re: [Practiceimprovemen t1] oopsTo: Practiceimprovement 1yahoogroups (DOT) .comDate: Saturday, August 30, 2008, 7:12 PM

Head count #3?I often collect copays but I we have a problem with outstanding bills. I too find it hard to address the issue of outstanding debt with patients. ReneNOTICE: This email (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender by email or by telephone at 1 and DELETE the original message from your system. Thank you for your cooperation."He is no fool who gives what he cannot keep to gain what he cannot lose"-- Annie SkaggsLexington, KY

[Guest guest]

Then you say something like ‘…your

insurance company set this rule as part of your contract with them.’

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

www.PinnacleFamilyMedicine.com

From: [mailto: ] On Behalf Of Wayne Coghill

Sent: Tuesday, September 02, 2008

6:25 AM

To:

Subject: Re:

oops

What's tougher is when the patient's say " I don't think I should

have to pay the copay on this visit because <insert reason here> "

Re: oops

head count #2 . yes. of

course but

I do have a biller and I like that I can share talking with patietns with

bill problems with her She is very sweet and often fixes things and the

team work with her is very nice

It takes some gettin g used to to ask for money

Sometimespatietns just don;t understand truly The card says

right on it 15.00 office vsit and tehy might not know. Alway s good

to defer to Them

" yep that;s what They say right here " I say

I mean I do not make theri isiruance rules

To my mediciad patietns I say things a bit differnlty They have a

3.oo copay but while I desperalty want it they do not have any money these

folks One guy was going to walk to see me yesterady 10 miles but he

got his dad's care as long as he picked dad up at the mill at 4 am.

For th em I say " Can you do your 3.00 copay? "

They say can I pay next time, about 3/4 of the itme Sometimes

i have given THEM money like for gas.One I bought some one;s meds

for them - they paid me back later

It is always good for you, a family doc ,to have like, a

wife with a good job in town ( alsaka homestaeders phrase) if you want

money But you will get used to asking and you will find your own way to

do it

welcome

On Sat, Aug 30, 2008 at 6:37 PM, Seto

wrote:

Sangeetha,

Welcome to the listserve. I don't think you can have

it both ways:

1. No third party interfering between you and the

patient AND

2. No direct payment from the patient to you.

Yeah, it makes me uncomfortable asking for money, but

I do it because it reinforces the concept that YOU are providing the service

and the patient is paying YOU. You can put an employee between you and the

patient just to collect the " filthy lucre " but that's still a third

party and you are already questioning the reliability of such a person. Is it

worth the extra cost just so you don't have to touch the money?

Money is not a bad thing. Really. You are not treating

patients out of the goodness of your heart (at least I don't think you are) and

your patients should know this. No margin = no mission. I think this is one

reason why doctors allowed ourselves to get into this whole 3rd party insurance

mess. We didn't want to get involved with the money. Well, see how well

that has turned out?

Let's do a head count. How many physicians here ever

actually ask for or collect money from your patients? I do.

Seto

South

Pasadena, CA

I

think the first message took off..

Anyhow, hello everyone I am new here. I will be moving my practice to

a low overhead model (I cannot call it IMP yet- I will not give cell

phone acess). I will have a staffer , less space, less telecom

expenditure than my current expense sharing setup. My question is -

the part of accepting payments really gets in the way of the patient

physician relationship. In the absence of a staffer what do you guys

do> Bill pay, preprinted invoices, autocheckin kiosks?

I expect to take my time to find the right person ( ya right!), will

have to account for absences and sickness and want to set up a smooth

workflow for copay collection that doesnt involve the patient seeing

me as collecting the money.

Thanks

SM

--

If you are a patient please allow up to 12 hours for a reply by email/

please note the new email address.

Remember that e-mail may not be entirely secure/

MD

ph fax

[Guest guest]

Sangeetha,You wrote "Its the $5 copays that I have a problem with. That requires a little resetting of expectations." I don't know if you mean a resetting of your patient's expectations or yours. My experience has been that most patients know that they have a copay and those that don't know are more than willing to pay it. Forgive me if I am interpreting this incorrectly but it sounds like you don't have a problem with asking patients to pay AFTER they leave your office, but that you might have a problem asking them to pay while they are STILL IN your office. One of the tenets of the GTD (Getting Things Done) system is to do things in context and if it can be done in 2 minutes or less, then you should just do it and get it off your plate. You're much more likely to get patients to pay their copays at the time of service than if you send them a bill even a few days later. (I always wait until after the visit is done but when I go see my doctor at Kaiser they always charge me up front.)Being able to take credit cards give patients more options to pay you (and less of an excuse not to pay you). Setting up a PayPal account gives patients yet another option but seems more appropriate for payment of their balances, rather than the copay which most insurance plan contracts state that you MUST charge patients at the time of service. You should put it in writing in your Payment Policy Statement. Here is a sample:Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.Some of us do keep credit card numbers on file, so that is another way to make sure you get paid. Personally, I do ask patients to voluntarily keep a credit card on file but I don't use it for copays because the credit card companies take a small percentage of every charge that you make. I will keep more money if the patient pays me by cash or check. Here are links to 2 articles from Family Practice Management that discuss the issue of copays and practice payment policies:http://www.aafp.org/fpm/20020500/19deal.htmlhttp://www.aafp.org/fpm/20040400/17whye.htmlFinally, I haven't heard many people on the listserve talk about sending patients to collections. At what point do you decide to do that? Do you have a high percentage of patients that require being sent to collections, and what kind of return do you get from the collection agency? SetoSouth Pasadena, CAHello,Thank you for all your responses.I have ABSOLUTELY no problem asking for payment for the full visitcharge , delinquent bills etc. In fact, fairly routinely dischargepatients and send them to collections if they have balances/ nomitigating circumstances even in my current set up.Its the $5 copays that I have a problem with. That requires a littleresetting of expectations.And I appreciate 's input.That hasceratinly stiffened my spine!I am really looking for a GTD kind ofsolution that requires little human interaction, and so no quibbles onanybody's part. 1.PAYpal ebills?, 2.keeping card on file(esp for hmo patients who have signed up to see you and you alone on aconsistent basis. yeah , I have a a few hmo patients which I seem tohave figured out how to manage, not yet onerous, with online referralsetc etc), 3.not collecting at time of service and having external billers bill?-since they get percentage of collections anyway.(I do not do my own billing-tended to want to chase every penny - whenI last did that -for 2 yrs)Any thoughts and any ecperiences with that.Thanks again everybodySangeetha

[Guest guest]

Sangeetha- agree with But I also am not clear on whose expectations need to be set or why?MAy I suggest we remove all these emotions??( docs complain about insurances patients complain about insruacnes) and use the simple technique AS MICHELE SAYS -with saying less .

It is like asking a 2 yr old something They will say no if given the opportunity So ,no oportunity Say " you have a 5.00 co pay How did you want to pay that? " You do not have to justify it or wish health care were different or anything else

I have been in the Chicago convention center and seen EAds talk to patietns and she is l ike the most nicest person on the face of the earth but she doesn;t wrangle over emotional stuff . Sh e gives postive simple choices " you can two things YOu can goto the web site and do an e vist or.. " i forgot what the other choice was...'

Keep it simple Does that help?Or tell us why you h ave 5.00 trouble and not 150.00 trouble.

Sangeetha,You wrote " Its the $5 copays that I have a problem with. That requires a little resetting of expectations. " I don't know if you mean a resetting of your patient's expectations or yours. My experience has been that most patients know that they have a copay and those that don't know are more than willing to pay it. Forgive me if I am interpreting this incorrectly but it sounds like you don't have a problem with asking patients to pay AFTER they leave your office, but that you might have a problem asking them to pay while they are STILL IN your office.

One of the tenets of the GTD (Getting Things Done) system is to do things in context and if it can be done in 2 minutes or less, then you should just do it and get it off your plate. You're much more likely to get patients to pay their copays at the time of service than if you send them a bill even a few days later. (I always wait until after the visit is done but when I go see my doctor at Kaiser they always charge me up front.)

Being able to take credit cards give patients more options to pay you (and less of an excuse not to pay you). Setting up a PayPal account gives patients yet another option but seems more appropriate for payment of their balances, rather than the copay which most insurance plan contracts state that you MUST charge patients at the time of service. You should put it in writing in your Payment Policy Statement. Here is a sample:

Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.

Some of us do keep credit card numbers on file, so that is another way to make sure you get paid. Personally, I do ask patients to voluntarily keep a credit card on file but I don't use it for copays because the credit card companies take a small percentage of every charge that you make. I will keep more money if the patient pays me by cash or check.

Here are links to 2 articles from Family Practice Management that discuss the issue of copays and practice payment policies:http://www.aafp.org/fpm/20020500/19deal.html

http://www.aafp.org/fpm/20040400/17whye.htmlFinally, I haven't heard many people on the listserve talk about sending patients to collections. At what point do you decide to do that? Do you have a high percentage of patients that require being sent to collections, and what kind of return do you get from the collection agency?

SetoSouth Pasadena, CA

Hello,Thank you for all your responses.I have ABSOLUTELY no problem asking for payment for the full visit

charge , delinquent bills etc. In fact, fairly routinely dischargepatients and send them to collections if they have balances/ nomitigating circumstances even in my current set up.Its the $5 copays that I have a problem with. That requires a little

resetting of expectations.And I appreciate 's input.That hasceratinly stiffened my spine!I am really looking for a GTD kind ofsolution that requires little human interaction, and so no quibbles onanybody's part.

1.PAYpal ebills?, 2.keeping card on file(esp for hmo patients who have signed up to see you and you alone on aconsistent basis. yeah , I have a a few hmo patients which I seem tohave figured out how to manage, not yet onerous, with online referrals

etc etc), 3.not collecting at time of service and having external billers bill?-since they get percentage of collections anyway.(I do not do my own billing-tended to want to chase every penny - when

I last did that -for 2 yrs)Any thoughts and any ecperiences with that.Thanks again everybodySangeetha

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

“You are seeing the doctor; your

insurance plan requires you to pay a copay for each doctor visit.”

(We usually get this when they’re

coming back “just” for lab results. I think it’s

particularly confusing if the patients see surgeons or whatnot that have

bundled services. But, of course, we don’t bundle anything because we

don’t do any procedures, except for a few minor ones.)

Pratt

Office Manager

Oak Tree Internal Medicine P.C.

From: [mailto: ] On Behalf Of Wayne Coghill

Sent: Tuesday, September 02, 2008

5:25 AM

To:

Subject: Re:

oops

What's tougher is when the patient's say " I don't think I should

have to pay the copay on this visit because <insert reason here> "

,___

[Guest guest]

This is getting better and better.

Its all about resetting expectations on the part of the patient. I

currently work with a practice that gives away a lot ...all in the

name of marketing/ customer development etc etc.It works for some of

the expense sharing partners who see a lot of patients a day- so what

they give away is a miniscule portion while costing the less

productive( nice word that)partners a lot

So patients think nothing of asking that they not be " nickel and

dimeD " . I heartily disagree and thats why we are parting ways. I can

see that the first few months will be a little difficult- but

appreciate all the tips you have given me.

On another note- I am looking at 4patientcare and appointment quest as

webschedulers. Does anybody have experience with 4 patientcare.com. I

will also be using Amazing charts

Thanks