RE: Send to Collection?

April 18, 2012

Tough situation…..but would just chalk it up to the price of experience and let it go…..probably will create more headaches for you to pursue….good luck… From: [mailto: ] On Behalf Of Wen LiangSent: Tuesday, April 17, 2012 11:33 PMTo: Subject: Send to Collection? Hi all, After opening my door for more than a year, I have one patient I would send to collection. I appreciate if you can give me advice. A new patient came in one late afternoon with two invalid insurance cards but no ID. After we insist, he went to his car and brought his passport. My assistant must be busy and didn't pay attention to our Phreesia check in pad alert on invalid insurances. The patient requested HTN meds refill and Narcotic Rx of #360 tablets because he was going abroad next day, and of course, he switched PCP... I tried to log into CURES, the California Prescription Drug Monitoring Program, but my password didn't work at that time. CURES has very strict rules about password, it just didn't work sometimes. I called them then realized because of the recent budget cut, the state dept no longer had a live person answering calls. In general, I have a policy of no Narcotic Rx on first visit. I kew there were so many red flags I should stay with my instincts. But When a morbid obese patient of 350 + lb complains of Low back pain, I believed him and wrote a much smaller amout of Narcotics as well as his BP meds. Later on I was able to log into CURES and found out he has been a doctor shopper. There were so many doctors ( license #s ) have been given him large amount of narcotics, like #360 tablets of Norco in 10 days. No one can consume that much Narcotic. So I reported him for suspicious activity, hoping someone can do something to stop him going to different doctors for controlled medications. By the time I called the Pharmacy, the meds were dispensed and pharmacy didn't have his ID because he paid cash. So some of the drug seeking acitivities must have not be recorded. A balance statement was sent to him a few weeks ago from my billing software. Today I got his response that he had file bankruptcy and " don't contact me anymore " . He wrote his case#. What a drama! Someone on the list said in the past primary care is more dramatic than a TV soap. I can't agree more. I don't feel too bad about the loss. But I do feel a little bit stupid that I was used and manipulated, after recognizing so many red flags. Now I am working on discharging him from my practice formally. My question is, could I send him to collection? And if one has filed bankruptcy, would collection make any difference to him or to me? Thank you for your advice and experience.Wen San Mateo, CA

April 18, 2012

hi wen,

my initial reaction was to be a little sarcastic to you...

but since it's a beautiful day today, think about it:

one little narcotic pill would probably have paid for your entire visit and more

on the streets..

g

>

> Hi all,

>

> After opening my door for more than a year, I have one patient I would send

> to collection. I appreciate if you can give me advice.

>

> A new patient came in one late afternoon with two invalid insurance cards

> but no ID. After we insist, he went to his car and brought his passport.

> My assistant must be busy and didn't pay attention to our Phreesia check in

> pad alert on invalid insurances. The patient requested HTN meds refill and

> Narcotic Rx of #360 tablets because he was going abroad next day, and of

> course, he switched PCP... I tried to log into CURES, the California

> Prescription Drug Monitoring Program, but my password didn't work at that

> time. CURES has very strict rules about password, it just didn't work

> sometimes. I called them then realized because of the recent budget cut,

> the state dept no longer had a live person answering calls. In general, I

> have a policy of no Narcotic Rx on first visit. I kew there were so many

> red flags I should stay with my instincts. But When a morbid obese patient

> of 350 + lb complains of Low back pain, I believed him and wrote a much

> smaller amout of Narcotics as well as his BP meds. Later on I was able to

> log into CURES and found out he has been a doctor shopper. There were so

> many doctors ( license #s ) have been given him large amount of narcotics,

> like #360 tablets of Norco in 10 days. No one can consume that much

> Narcotic. So I reported him for suspicious activity, hoping someone can do

> something to stop him going to different doctors for controlled

> medications. By the time I called the Pharmacy, the meds were dispensed

> and pharmacy didn't have his ID because he paid cash. So some of the drug

> seeking acitivities must have not be recorded.

>

> A balance statement was sent to him a few weeks ago from my billing

> software. Today I got his response that he had file bankruptcy and " don't

> contact me anymore " . He wrote his case#. What a drama! Someone on the list

> said in the past primary care is more dramatic than a TV soap. I can't

> agree more. I don't feel too bad about the loss. But I do feel a little bit

> stupid that I was used and manipulated, after recognizing so many red

> flags. Now I am working on discharging him from my practice formally.

>

> My question is, could I send him to collection? And if one has filed

> bankruptcy, would collection make any difference to him or to me?

>

> Thank you for your advice and experience.

> Wen

> San Mateo, CA

>

April 18, 2012

You will have to look up the bankruptcy 7 vs 13. But I think it prohibits you from even contacting for collecting, let alone filing a collections claim (at least for a grace period). His credit has probably been trashed with the bankruptcy. I doubt you want to get into it, but you can always file with the police for insurance fraud.

g

To: Sent: Wednesday, April 18, 2012 6:55 AMSubject: Re: Send to Collection?

hi wen,my initial reaction was to be a little sarcastic to you... :)but since it's a beautiful day today, think about it:one little narcotic pill would probably have paid for your entire visit and more on the streets..g>> Hi all,> > After opening my door for more than a year, I have one patient I would send> to collection. I appreciate if you can give me advice.> > A new patient came in one late afternoon with two invalid insurance cards> but no ID. After we insist, he went to his car and brought his passport.> My assistant must be busy and didn't pay attention to our Phreesia check in> pad alert on invalid insurances. The

patient requested HTN meds refill and> Narcotic Rx of #360 tablets because he was going abroad next day, and of> course, he switched PCP... I tried to log into CURES, the California> Prescription Drug Monitoring Program, but my password didn't work at that> time. CURES has very strict rules about password, it just didn't work> sometimes. I called them then realized because of the recent budget cut,> the state dept no longer had a live person answering calls. In general, I> have a policy of no Narcotic Rx on first visit. I kew there were so many> red flags I should stay with my instincts. But When a morbid obese patient> of 350 + lb complains of Low back pain, I believed him and wrote a much> smaller amout of Narcotics as well as his BP meds. Later on I was able to> log into CURES and found out he has been a doctor shopper. There were so> many doctors ( license #s ) have

been given him large amount of narcotics,> like #360 tablets of Norco in 10 days. No one can consume that much> Narcotic. So I reported him for suspicious activity, hoping someone can do> something to stop him going to different doctors for controlled> medications. By the time I called the Pharmacy, the meds were dispensed> and pharmacy didn't have his ID because he paid cash. So some of the drug> seeking acitivities must have not be recorded.> > A balance statement was sent to him a few weeks ago from my billing> software. Today I got his response that he had file bankruptcy and "don't> contact me anymore". He wrote his case#. What a drama! Someone on the list> said in the past primary care is more dramatic than a TV soap. I can't> agree more. I don't feel too bad about the loss. But I do feel a little bit> stupid that I was used and manipulated, after

recognizing so many red> flags. Now I am working on discharging him from my practice formally.> > My question is, could I send him to collection? And if one has filed> bankruptcy, would collection make any difference to him or to me?> > Thank you for your advice and experience.> Wen> San Mateo, CA>

April 18, 2012

OK, so I will admit I have had similar problems, I have sent people to collections. It is a pain, the firm I use requires I print out stuff, I get paid on only about 1/3 of the people I send there and because I wait so long to send them and the percentage the collections people keep is related to how old the debt is the collections people usually get like 30 % of it. But... this is just the kind of thing I would send, I don't know, maybe I am vindictive or something. I have lots of people that I don't send because I know they don't have money or whatever or I somehow feel I made a billing or insurance mistake. Kris

hi wen,my initial reaction was to be a little sarcastic to you... :)but since it's a beautiful day today, think about it:one little narcotic pill would probably have paid for your entire visit and more on the streets..g>> Hi all,> > After opening my door for more than a year, I have one patient I would send> to collection. I appreciate if you can give me advice.> > A new patient came in one late afternoon with two invalid insurance cards> but no ID. After we insist, he went to his car and brought his passport.> My assistant must be busy and didn't pay attention to our Phreesia check in> pad alert on invalid insurances. The patient requested HTN meds refill and> Narcotic Rx of #360 tablets because he was going abroad next day, and of> course, he switched PCP... I tried to log into CURES, the California> Prescription Drug Monitoring Program, but my password didn't work at that> time. CURES has very strict rules about password, it just didn't work> sometimes. I called them then realized because of the recent budget cut,> the state dept no longer had a live person answering calls. In general, I> have a policy of no Narcotic Rx on first visit. I kew there were so many> red flags I should stay with my instincts. But When a morbid obese patient> of 350 + lb complains of Low back pain, I believed him and wrote a much> smaller amout of Narcotics as well as his BP meds. Later on I was able to> log into CURES and found out he has been a doctor shopper. There were so> many doctors ( license #s ) have been given him large amount of narcotics,> like #360 tablets of Norco in 10 days. No one can consume that much> Narcotic. So I reported him for suspicious activity, hoping someone can do> something to stop him going to different doctors for controlled> medications. By the time I called the Pharmacy, the meds were dispensed> and pharmacy didn't have his ID because he paid cash. So some of the drug> seeking acitivities must have not be recorded.> > A balance statement was sent to him a few weeks ago from my billing> software. Today I got his response that he had file bankruptcy and "don't> contact me anymore". He wrote his case#. What a drama! Someone on the list> said in the past primary care is more dramatic than a TV soap. I can't> agree more. I don't feel too bad about the loss. But I do feel a little bit> stupid that I was used and manipulated, after recognizing so many red> flags. Now I am working on discharging him from my practice formally.> > My question is, could I send him to collection? And if one has filed> bankruptcy, would collection make any difference to him or to me?> > Thank you for your advice and experience.> Wen> San Mateo, CA>

April 18, 2012

So I called Collection company today and they were helpful. He is still financially responsible for his expense after he filed bankruptcy. He may not care about his credit scores and not pay any way. But this is at least what I can do, hoping to stop him from doctors shopping for huge amount of Narcotics.

Thank you for advice. Wen

OK, so I will admit I have had similar problems, I have sent people to collections. It is a pain, the firm I use requires I print out stuff, I get paid on only about 1/3 of the people I send there and because I wait so long to send them and the percentage the collections people keep is related to how old the debt is the collections people usually get like 30 % of it. But... this is just the kind of thing I would send, I don't know, maybe I am vindictive or something. I have lots of people that I don't send because I know they don't have money or whatever or I somehow feel I made a billing or insurance mistake. Kris

hi wen,my initial reaction was to be a little sarcastic to you... :)but since it's a beautiful day today, think about it:one little narcotic pill would probably have paid for your entire visit and more on the streets..g>> Hi all,> > After opening my door for more than a year, I have one patient I would send> to collection. I appreciate if you can give me advice.> > A new patient came in one late afternoon with two invalid insurance cards> but no ID. After we insist, he went to his car and brought his passport.> My assistant must be busy and didn't pay attention to our Phreesia check in> pad alert on invalid insurances. The patient requested HTN meds refill and> Narcotic Rx of #360 tablets because he was going abroad next day, and of> course, he switched PCP... I tried to log into CURES, the California> Prescription Drug Monitoring Program, but my password didn't work at that> time. CURES has very strict rules about password, it just didn't work> sometimes. I called them then realized because of the recent budget cut,> the state dept no longer had a live person answering calls. In general, I> have a policy of no Narcotic Rx on first visit. I kew there were so many> red flags I should stay with my instincts. But When a morbid obese patient> of 350 + lb complains of Low back pain, I believed him and wrote a much> smaller amout of Narcotics as well as his BP meds. Later on I was able to> log into CURES and found out he has been a doctor shopper. There were so> many doctors ( license #s ) have been given him large amount of narcotics,> like #360 tablets of Norco in 10 days. No one can consume that much> Narcotic. So I reported him for suspicious activity, hoping someone can do> something to stop him going to different doctors for controlled> medications. By the time I called the Pharmacy, the meds were dispensed> and pharmacy didn't have his ID because he paid cash. So some of the drug> seeking acitivities must have not be recorded.> > A balance statement was sent to him a few weeks ago from my billing> software. Today I got his response that he had file bankruptcy and " don't> contact me anymore " . He wrote his case#. What a drama! Someone on the list> said in the past primary care is more dramatic than a TV soap. I can't> agree more. I don't feel too bad about the loss. But I do feel a little bit> stupid that I was used and manipulated, after recognizing so many red> flags. Now I am working on discharging him from my practice formally.> > My question is, could I send him to collection? And if one has filed> bankruptcy, would collection make any difference to him or to me?> > Thank you for your advice and experience.> Wen> San Mateo, CA>

April 18, 2012

I think in little practices it feels more like a violation of th erelationshipI sned some people and I pick and hoose. T$he ones I sned are the ones who hung up on me or get at mad that I ask them to pay 5 or 10.00 etc The ones who have nothing including a guy who owes me $ 1200.00 and after being unemployed for 2 yrs( many visits many troubles) JUSt got ajob and offered me 150 yestreday when I was about to pen mymouth and say about 75( towards the baalnce) Some people stick by you and you can stick by them others willnever pay anyway and collections is a tool that is mildly usefulAnd can be tough in a small community Denver may feel differnt than Worhtignton ohio or Newport News .

OK, so I will admit I have had similar problems, I have sent people to collections. It is a pain, the firm I use requires I print out stuff, I get paid on only about 1/3 of the people I send there and because I wait so long to send them and the percentage the collections people keep is related to how old the debt is the collections people usually get like 30 % of it. But... this is just the kind of thing I would send, I don't know, maybe I am vindictive or something. I have lots of people that I don't send because I know they don't have money or whatever or I somehow feel I made a billing or insurance mistake. Kris

hi wen,my initial reaction was to be a little sarcastic to you... :)but since it's a beautiful day today, think about it:one little narcotic pill would probably have paid for your entire visit and more on the streets..g>> Hi all,> > After opening my door for more than a year, I have one patient I would send> to collection. I appreciate if you can give me advice.> > A new patient came in one late afternoon with two invalid insurance cards> but no ID. After we insist, he went to his car and brought his passport.> My assistant must be busy and didn't pay attention to our Phreesia check in> pad alert on invalid insurances. The patient requested HTN meds refill and> Narcotic Rx of #360 tablets because he was going abroad next day, and of> course, he switched PCP... I tried to log into CURES, the California> Prescription Drug Monitoring Program, but my password didn't work at that> time. CURES has very strict rules about password, it just didn't work> sometimes. I called them then realized because of the recent budget cut,> the state dept no longer had a live person answering calls. In general, I> have a policy of no Narcotic Rx on first visit. I kew there were so many> red flags I should stay with my instincts. But When a morbid obese patient> of 350 + lb complains of Low back pain, I believed him and wrote a much> smaller amout of Narcotics as well as his BP meds. Later on I was able to> log into CURES and found out he has been a doctor shopper. There were so> many doctors ( license #s ) have been given him large amount of narcotics,> like #360 tablets of Norco in 10 days. No one can consume that much> Narcotic. So I reported him for suspicious activity, hoping someone can do> something to stop him going to different doctors for controlled> medications. By the time I called the Pharmacy, the meds were dispensed> and pharmacy didn't have his ID because he paid cash. So some of the drug> seeking acitivities must have not be recorded.> > A balance statement was sent to him a few weeks ago from my billing> software. Today I got his response that he had file bankruptcy and " don't> contact me anymore " . He wrote his case#. What a drama! Someone on the list> said in the past primary care is more dramatic than a TV soap. I can't> agree more. I don't feel too bad about the loss. But I do feel a little bit> stupid that I was used and manipulated, after recognizing so many red> flags. Now I am working on discharging him from my practice formally.> > My question is, could I send him to collection? And if one has filed> bankruptcy, would collection make any difference to him or to me?> > Thank you for your advice and experience.> Wen> San Mateo, CA>

-- MD ph fax

April 18, 2012

c'mon you guys.

the mechanic, costco, walmart, their hairdresser, dont give percentages of their

groceries and professional bill.

why do you feel bad about collecting what you are due? after the fact that they

have just been given a pay-in-90-days bill for an office visit that may have

saved their life?

you might feel bad about him. say one pill is $25 on the streets. and if he is

selling, he is actually making more than you a day.

grace

April 18, 2012

Are u for sure he file for bankarrupkcy?He can tell u he is Elvis re-incarnation ,He tricked u, I would send him to collections.I don't know how to do itAdolfo E. Teran, MD

Hi all, After opening my door for more than a year, I have one patient I would send to collection. I appreciate if you can give me advice. A new patient came in one late afternoon with two invalid insurance cards but no ID. After we insist, he went to his car and brought his passport. My assistant must be busy and didn't pay attention to our Phreesia check in pad alert on invalid insurances. The patient requested HTN meds refill and Narcotic Rx of #360 tablets because he was going abroad next day, and of course, he switched PCP... I tried to log into CURES, the California Prescription Drug Monitoring Program, but my password didn't work at that time. CURES has very strict rules about password, it just didn't work sometimes. I called them then realized because of the recent budget cut, the state dept no longer had a live person answering calls. In general, I have a policy of no Narcotic Rx on first visit. I kew there were so many red flags I should stay with my instincts. But When a morbid obese patient of 350 + lb complains of Low back pain, I believed him and wrote a much smaller amout of Narcotics as well as his BP meds. Later on I was able to log into CURES and found out he has been a doctor shopper. There were so many doctors ( license #s ) have been given him large amount of narcotics, like #360 tablets of Norco in 10 days. No one can consume that much Narcotic. So I reported him for suspicious activity, hoping someone can do something to stop him going to different doctors for controlled medications. By the time I called the Pharmacy, the meds were dispensed and pharmacy didn't have his ID because he paid cash. So some of the drug seeking acitivities must have not be recorded.

A balance statement was sent to him a few weeks ago from my billing software. Today I got his response that he had file bankruptcy and "don't contact me anymore". He wrote his case#. What a drama! Someone on the list said in the past primary care is more dramatic than a TV soap. I can't agree more. I don't feel too bad about the loss. But I do feel a little bit stupid that I was used and manipulated, after recognizing so many red flags. Now I am working on discharging him from my practice formally.

My question is, could I send him to collection? And if one has filed bankruptcy, would collection make any difference to him or to me? Thank you for your advice and experience.

Wen San Mateo, CA

=

April 19, 2012

Yes, you aren't going to be able to collect once they file for bankruptcy, but I like the idea of insurance fraud, but of who, since no valid insurance was given, can't turn him in to his insurance, and you already turned him in to the state. Deep breath, write a letter firing him formally, which you should have done immediately, and let it go.

CCote

To: Sent: Wednesday, April 18, 2012 8:01:08 AMSubject: Re: Re: Send to Collection?

You will have to look up the bankruptcy 7 vs 13. But I think it prohibits you from even contacting for collecting, let alone filing a collections claim (at least for a grace period). His credit has probably been trashed with the bankruptcy. I doubt you want to get into it, but you can always file with the police for insurance fraud.

g

To: Sent: Wednesday, April 18, 2012 6:55 AMSubject: Re: Send to Collection?

hi wen,my initial reaction was to be a little sarcastic to you... :)but since it's a beautiful day today, think about it:one little narcotic pill would probably have paid for your entire visit and more on the streets..g>> Hi all,> > After opening my door for more than a year, I have one patient I would send> to collection. I appreciate if you can give me advice.> > A new patient came in one late afternoon with two invalid insurance cards> but no ID. After we insist, he went to his car and brought his passport.> My assistant must be busy and didn't pay attention to our Phreesia check in> pad alert on invalid insurances. The patient requested HTN meds refill and> Narcotic Rx of #360 tablets because he was going abroad next day, and of> course, he switched PCP... I tried to log into CURES, the California> Prescription Drug Monitoring Program, but my password didn't work at that> time. CURES has very strict rules about password, it just didn't work> sometimes. I called them then realized because of the recent budget cut,> the state dept no longer had a live person answering calls. In general, I> have a policy of no Narcotic Rx on first visit. I kew there were so many> red flags I should stay with my instincts. But When a morbid obese patient> of 350 + lb complains of Low back pain, I believed him and wrote a much> smaller amout of Narcotics as well as his BP meds. Later on I was able to> log into CURES and found out he has been a doctor shopper. There were so> many doctors ( license #s ) have been given him large amount of narcotics,> like #360 tablets of Norco in 10 days. No one can consume that much> Narcotic. So I reported him for suspicious activity, hoping someone can do> something to stop him going to different doctors for controlled> medications. By the time I called the Pharmacy, the meds were dispensed> and pharmacy didn't have his ID because he paid cash. So some of the drug> seeking acitivities must have not be recorded.> > A balance statement was sent to him a few weeks ago from my billing> software. Today I got his response that he had file bankruptcy and "don't> contact me anymore". He wrote his case#. What a drama! Someone on the list> said in the past primary care is more dramatic than a TV soap. I can't> agree more. I don't feel too bad about the loss. But I do feel a little bit> stupid that I was used and manipulated, after recognizing so many red> flags. Now I am working on discharging him from my practice formally.> > My question is, could I send him to collection? And if one has filed> bankruptcy, would collection make any difference to him or to me?> > Thank you for your advice and experience.> Wen> San Mateo, CA>

April 19, 2012

Good answer, bankruptcy is public record, you can look up on line, if not there he may be lying. Usually if they are honest and included you in their list of debts, you get something from the state saying, this person filed for bankruptcy and you are SOL you can't collect. Have you gotten that? Have been doing this 8 yr, 1 bankruptcy in patient pop in first 5, at least 5 in last 3 yr.

CCote

To: Sent: Wednesday, April 18, 2012 2:20:38 PMSubject: Re: Send to Collection?

Are u for sure he file for bankarrupkcy?

He can tell u he is Elvis re-incarnation ,

He tricked u, I would send him to collections.

I don't know how to do itAdolfo E. Teran, MD

Hi all,

After opening my door for more than a year, I have one patient I would send to collection. I appreciate if you can give me advice.

A new patient came in one late afternoon with two invalid insurance cards but no ID. After we insist, he went to his car and brought his passport. My assistant must be busy and didn't pay attention to our Phreesia check in pad alert on invalid insurances. The patient requested HTN meds refill and Narcotic Rx of #360 tablets because he was going abroad next day, and of course, he switched PCP... I tried to log into CURES, the California Prescription Drug Monitoring Program, but my password didn't work at that time. CURES has very strict rules about password, it just didn't work sometimes. I called them then realized because of the recent budget cut, the state dept no longer had a live person answering calls. In general, I have a policy of no Narcotic Rx on first visit. I kew there were so many red flags I should stay with my instincts. But When a morbid obese patient of 350 + lb complains of Low back pain, I believed him and wrote a much smaller amout of Narcotics as well as his BP meds. Later on I was able to log into CURES and found out he has been a doctor shopper. There were so many doctors ( license #s ) have been given him large amount of narcotics, like #360 tablets of Norco in 10 days. No one can consume that much Narcotic. So I reported him for suspicious activity, hoping someone can do something to stop him going to different doctors for controlled medications. By the time I called the Pharmacy, the meds were dispensed and pharmacy didn't have his ID because he paid cash. So some of the drug seeking acitivities must have not be recorded.

A balance statement was sent to him a few weeks ago from my billing software. Today I got his response that he had file bankruptcy and "don't contact me anymore". He wrote his case#. What a drama! Someone on the list said in the past primary care is more dramatic than a TV soap. I can't agree more. I don't feel too bad about the loss. But I do feel a little bit stupid that I was used and manipulated, after recognizing so many red flags. Now I am working on discharging him from my practice formally.

My question is, could I send him to collection? And if one has filed bankruptcy, would collection make any difference to him or to me?

Thank you for your advice and experience.

Wen

San Mateo, CA

=

April 19, 2012

Patient Collections: 5 Mistakes Your Practice Can Avoid

By Judy Capko | April 3, 2012

Many practices experience common accounts receivable (A/R) mistakes that when left unattended result in the nightmare of watching A/R soar and, sometimes, become unmanageable. Managing practice collections begins before the first patient visit and ends with a zero balance; all the while monitoring the key processes involved.

Mistake #1

It starts with the collection of insufficient or inaccurate financial data. This is an ongoing complaint from the billing and collections department. I hear everything from " the schedulers didn't obtain the right information when they scheduled the visit " to " no one verified benefits " to " it's errors with data entry. " All of these things are likely to lead to problem accounts and rising A/R, and may be an indication of a failure to provide employees with sufficient training, and a failure to monitor performance.

If your front-line staff is slipping, you can't ignore it. You must counsel them and provide additional training if necessary and hold each person accountable to a specific standard. It is also important to evaluate work flow — deciding what type of workload is reasonable for each person to manage, while producing quality output. This aspect of performance should count when it's time for annual performance reviews.

Mistake # 2

Garbage in, garbage out! Collecting accurate demographic and billing information should not be limited to new patients. Update patient information and insurance information at each visit. If a staff member fails to do this, hold him accountable.

You can use this chart to help your staff probe for and collect the right data when scheduling appointments, or at the beginning of each patient visit.

Mistake # 3

Another headache for practices is monitoring patients with aged balances who keep coming in for additional services. It's mind-boggling for staff to discover patients who fail to pay coming in for additional care and running up larger balances that will make it even harder to collect. The front desk needs to be trained and empowered to assist with collecting patient balances. Set up a system whereby accounts are reviewed one day before the patient visit; when there are existing patient balances, determine processes to support payment.

Begin by checking the account balance when a patient is scheduled, and let her know that payment is expected at the time of the visit. Follow up by reminding the patient again, when you make the reminder phone call a day or two before the visit. There should be no excuse for the patient not being prepared to pay. It's your staff's job to " ask " the patient for payment when she arrives at the office.

Receptionists and schedulers need to be trained on how to audit a patient's account and to know when it's time to have the patient meet with someone in the billing department. Determine the specific parameters for your staff so they can do the job you want and support each other. It takes a team!

Mistake # 4

Untimely submission of insurance claims and poorly designed patient statements will thwart collection efforts. It is also important to generate charges in " real time, " so charges are posted and electronically sent to the payer within 24 hours. Take a critical look at your patient statement to make sure it is easy for patients to understand what they should pay, as opposed to what is pending from the insurance company. This will expedite payment — and if patients can pay " online " so much the better.

Establish specific billing targets, such as:

• Charges must be submitted the day the service is rendered.

• Charges must be posted and insurance claims generated within 24 hours. (You might establish a longer time frame for surgical claims if you have a coder review the physician's op notes before submission.)

• Send patient statements within 10 days of service, and immediately following insurance payment.

• Statements should also include an aging of the balance and a dunning message for delinquent accounts. Most billing software allows you to customize your dunning messages and determine the criteria for when they should be placed on the patient statements.

Mistake # 5

Failure to analyze collection performance can be a major headache. Too often the staff is focused on getting the billing off their desk and the claims submitted, but have little time to follow up on receivables, analyze the practice's financial performance, and improve collections.

Monitoring overall performance requires consistently reviewing month-end reports and analyzing collection performance. There are reports that will reveal trends and help you identify where there are problems on the horizon:

• Unpaid claims • Aging reports• Aging by payer class • Patient balance reports • Payer performance reports

After analyzing collection performance ask yourself some key questions:

• Should we change what we are currently doing?• Can we increase automation?• Should we use a collection agency?• Does outsourcing make sense, and if so, to what degree?• Should we cancel " bottom feeder plans " ?

Finally, develop written financial policies. These policies should represent your philosophy and collection goals. The goals should be specific and identify employee responsibility. By including the entire staff in development and implementation of the policies, you get their buy-in, which is essential to achieving the desired results.

Judy Capko is a healthcare consultant and author of the popular books " Secrets of the Best Run Practices, " 2nd edition, and " Take Back Time. " Based in Thousand Oaks, Calif., she is a national speaker on healthcare topics. She can be reached at judy@....

Yes, you aren't going to be able to collect once they file for bankruptcy, but I like the idea of insurance fraud, but of who, since no valid insurance was given, can't turn him in to his insurance, and you already turned him in to the state. Deep breath, write a letter firing him formally, which you should have done immediately, and let it go.

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Sent: Wednesday, April 18, 2012 8:01:08 AMSubject: Re: Re: Send to Collection?

You will have to look up the bankruptcy 7 vs 13. But I think it prohibits you from even contacting for collecting, let alone filing a collections claim (at least for a grace period). His credit has probably been trashed with the bankruptcy. I doubt you want to get into it, but you can always file with the police for insurance fraud.