was AARP, changing to Medicare 20% in general

[Guest guest]

I am afraid that I believe that many offices simply do not bill the

patient if the ins. doesn't pay. I recently went to a Medicare

billing seminar where the presenters kept saying that it was illegal

not to try to bill the patient for the 20%, that writing it off as a

matter of practice is something that Medicare can come after you

for. She actually said, " I don't care if it is as little as sending

the patient 1 bill and that's it, but there has to be some good faith

effort to collect the 20% " I am pretty aggressive about biling (we

are struggling financially) and I hear from patients, " Why is this a

problem? My other doctor's offices don't have this problem. " (I

think the other offices write off an extraordinary amount, or don't

even realize what they are not collecting. I recently contacted the

one person support staff of other neurologist in town (she does his

billing) and she couldn't even tell me if they were in-network for a

certain local plan).

e-MDs does not allow us to charge the patient interest, which is

ludicrous. I have argued this with them and they announced, proudly,

that I could go in and add a custom code to every single overdue bill

to charge interest.

In general, I find that the work involved with collection of the

20% from the insurance co. is nuts, and we are hoping to go non-par

because I have better luck collecting it from the patients than from

the ins. companies. (Thanks to all the folks on the list serv who

have put posts about doing this.) We live in a poor area and I know

that we will lose patients by doing this, but I am too humiliated to

tell you all how little we will be making once we are off our income

guarantee.

[Guest guest]

Hi ,

We use e-MDs, too, and I print the

statement report each month before printing statements and compare it to the

previous month. After I realized how much work it was going to be to

calculate a % for late fees, we instituted a flat $5/month late fee in our

financial policy. It’s pretty easy to set up the custom CPT code

(we use XLT) and then each month I just adjust the units up and e-MDs changes

the charge. It makes patients pay their low balances pretty quickly if

they know that their $17.82 balance will be $22.82 next month and $27.82 the

following month. The larger balances, however, seem to be happy to sit

there accumulating late fees. We send 2 invoices after insurance is

received and start charging the $5/month late fee on the 3rd invoice.

Invoices 3-5 get a late fee letter, warning that we’ll send to

collections and Invoice #6 goes directly to the collections agency and a letter

to the patient telling them that they’ve been reported to collections. It

always amazes me how many patients don’t pay and then once the collection

agency calls, they’re ny-on-the-spot to pay their bill. I also

have the dunning notices set up on e-MDs to warn them about late fees. We’ve

also recently instituted a payment “Due on the 5th,”

rather than due upon receipt and I think that gives patients a more concrete

date in their head that they need to send it in to avoid late fees.

Another thing we have done is to start taking credit card numbers on an

authorization form for all of those patients with coinsurance. I put it

as a note in demographics “CC AUTH on file” and when I’m

posting their insurance payment, I can charge their CC at the same time and

avoid billing altogether.

Regarding the statement about “other

doctor’s offices” not having the problem….remember that those

“other” offices are all specialists – you are the PCP and the

underpaid. Of course you can’t mention this to the patients without

sounding whiney, but don’t feel guilty about billing the patients for

what they owe you.

BTW, we don’t send bills for less

than $5, we just collect at the next visit. Training the front desk to

look at the patient balance will help your collections, too, if they aren’t

already doing it.

Good luck!

Pratt

Office Manager

Oak Tree Internal Medicine P.C

Roy Medical Associates, Inc.

From: [mailto: ] On Behalf Of neurologymp

Sent: Wednesday, December 17, 2008

5:46 AM

To:

Subject:

was AARP, changing to Medicare 20% in general

I am afraid that I believe that many offices simply do

not bill the

patient if the ins. doesn't pay. I recently went to a Medicare

billing seminar where the presenters kept saying that it was illegal

not to try to bill the patient for the 20%, that writing it off as a

matter of practice is something that Medicare can come after you

for. She actually said, " I don't care if it is as little as sending

the patient 1 bill and that's it, but there has to be some good faith

effort to collect the 20% " I am pretty aggressive about biling (we

are struggling financially) and I hear from patients, " Why is this a

problem? My other doctor's offices don't have this problem. " (I

think the other offices write off an extraordinary amount, or don't

even realize what they are not collecting. I recently contacted the

one person support staff of other neurologist in town (she does his

billing) and she couldn't even tell me if they were in-network for a

certain local plan).

e-MDs does not allow us to charge the patient interest, which is

ludicrous. I have argued this with them and they announced, proudly,

that I could go in and add a custom code to every single overdue bill

to charge interest.

In general, I find that the work involved with collection of the

20% from the insurance co. is nuts, and we are hoping to go non-par

because I have better luck collecting it from the patients than from

the ins. companies. (Thanks to all the folks on the list serv who

have put posts about doing this.) We live in a poor area and I know

that we will lose patients by doing this, but I am too humiliated to

tell you all how little we will be making once we are off our income

guarantee.