Jump to content
RemedySpot.com

Time of Service Payments

Rate this topic


Guest guest

Recommended Posts

Guest guest

Hello to all,

I'm interested in getting feedback from the list regarding processes used

to successfully collect time of service payments from patients? Do you

inform patients before they are scheduled what their expected out of pocket will

be? Do you reschedule patients if they are unable to pay their copay,

coinsurance or deductible at the time of service? If yes, do patients return

when they are able to pay? Do you set up monthly payment plans for

patients who cannot pay at the time of service? If yes, what percentage do you

attempt to collect each month? Do you charge interest on uncollected account

balances? Do you turn patients over to collections? If yes, after how

many days past due? Any input is greatly appreciated.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guilbeau Road, Suite A

Lafayette, LA 70506

Link to comment
Share on other sites

Guest guest

Hi Vickie,

First of all the one thing that helped us collect co-pays more regularly is

when we finally got a credit card/merchant services machine. We now balance

the fees with improved co-pay management and improved cash flow.

Second, a lot has to do with where your clinic is located and the make-up of

the surrounding community. After we moved our clinic in 2004 (thanks to a

POPTS situation), we found that we could process our co-pays differently.

We no longer needed punitive measures as a whole as the community responded

better to a lower key approach.

Third we have had to change because of the increasing amounts of co-pays and

the burden they cause.

.. We attempt to collect co-pays at time of service however, we have

eliminated the heavy handed techniques of requiring it or having threatening

signs.

.. We give each client a handout at the time of evaluation that

explains our billing procedures including co-pays but also lets them know

that we are willing to work with them on options and that we hope that

payment does not effect getting them the care they need. The language on

this handout is matter of fact - no threats and more positive towards how

important it is that they get treatment without worrying so much about

payments.

.. We offer the option of paying co-pays at the time of service or

paying co-pays per week. Our seniors on Medicare Advantage programs that

have reasonable co-pays of $10 - 15 tend to like to pay weekly especially if

they are being seen 3X/week. It saves check fees for those still using

checks as well.

.. We do have an option of rolling the co-pays into the balance owed

and doing a payment plan. We start at $50.00 per month and only apply

interest to those accounts that are not paid on time (very rare in our

community). We have read and re-read our insurance contracts and none

specify that the co-pays have to be collected at the time of service. They

do specify that they should not be waived (see later about that option). We

have never been questioned on this so we continue to offer this. Generally

we offer only if we see that someone is hesitating about coming back to PT

because of the co-pay. We do the same with high deductibles and consider

this process the same as handling a client with a high deductible owed. I

would say that we do this in 10% of our co-pay cases.

.. We have very few cases that go to collections but the co-pays owed

become outstanding balances just like everything else so we have had cases

go to collections which involved unpaid co-pays as part of the unpaid

balance. Again it has been very few (yes we know we are lucky!). Since we

have so few go to collections, we have been slow in turning them over. We

make a few attempts to contact the client by mail, then by phone and record

each effort in the chart. I would say that it is at least 3 months after

their last visit that it goes to collections.

.. We do have a process by which we can legitimately waive co-pays

and that is okay with insurances. We have not had to use it yet but it is

available. In the case of severe financial hardship, we would ask the

client to fill out a financial statement and keep a copy in their record.

We have a form that each of us would sign officially stating the co-pay is

waived and why. In addition, we have a full policy written explaining the

process. These elements meet the requirements we have seen and have been

educated on as to how co-pays can be waived: have clear policy and

procedure, use a financial statement and have a copy in the record and fill

out a form stating why the co-pay is waived. We know that we cannot use

this process except in very rare cases but it is good that we have it

available.

.. We have staff that is excellent at collecting co-pays and in fact

we have removed it from quality improvement process because we were

consistently in the high 90% at collecting co-pays. I do recommend that

clinics do their own quality improvement process to make sure that staff id

attempting to collect, especially in larger clinics where missed co-pays can

add up fast.

Take all of this with keeping in mind that our procedures are quite

different from many clinics. We don't have any specific research that our

procedures, which take away the heavy handedness of requesting co-pays at

the time of service or threatening to pull service if co-pays are not paid,

works but we do know that we get paid regularly and 90% at the time of

service. Anecdotally, we know that many find the low key approach more

friendly and helpful to them. I think ultimately you have to know your

community and know what will work best. Business-wise, it is still strongly

recommended that co-pays are collected at time of service and I am sure that

some will discuss the importance of paying at the time of service to show

the reason for the co-pay - shared responsibility. I don't disagree with

that but also say that I have not ever seen where a person understanding the

shared responsibility of co-pays ever acted or reacted different in therapy.

To them it is just another payment that has to be made. We have just tried

to reduce the punitive techniques and turn it into a positive experience.

Clients know that their payment counts and helps us stay in business, it is

just down in a more low key way. We would like to think that our methods

would allow improved co-pay collection in any community but again, we have

no proof of this. We would like to think that we do so well at collecting

co-pays and have so few cases go to collections because of our procedures

but again we have no proof. What we do have is most co-pays collected at

time of service and few cases going to collections which ultimately is the

important measure no matter what methods are used.

Hope that helps!

M. Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

From: PTManager [mailto:PTManager ] On Behalf

Of mlavcavitt@...

Sent: Tuesday, April 26, 2011 6:45 AM

To: PTManager

Subject: Time of Service Payments

Hello to all,

I'm interested in getting feedback from the list regarding processes used

to successfully collect time of service payments from patients? Do you

inform patients before they are scheduled what their expected out of pocket

will

be? Do you reschedule patients if they are unable to pay their copay,

coinsurance or deductible at the time of service? If yes, do patients return

when they are able to pay? Do you set up monthly payment plans for

patients who cannot pay at the time of service? If yes, what percentage do

you

attempt to collect each month? Do you charge interest on uncollected account

balances? Do you turn patients over to collections? If yes, after how

many days past due? Any input is greatly appreciated.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guilbeau Road, Suite A

Lafayette, LA 70506

Link to comment
Share on other sites

Guest guest

Dear ,

Thank you so much for the wealth of information. I have a very special

client that would prefer not to implement punitive measures for patients that

do not or are not able to pay at the time of service. We are looking for

any and all options to assist him in this process as he is having

difficulties collecting from patients at the TOS. You have given me a number

of

ideas to assist him. For this, I am grateful.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guidry Street, Suite A

Lafayette, LA 70506

In a message dated 4/26/2011 12:53:53 P.M. Central Daylight Time,

thowell@... writes:

Hi Vickie,

First of all the one thing that helped us collect co-pays more regularly is

when we finally got a credit card/merchant services machine. We now balance

the fees with improved co-pay management and improved cash flow.

Second, a lot has to do with where your clinic is located and the make-up

of

the surrounding community. After we moved our clinic in 2004 (thanks to a

POPTS situation), we found that we could process our co-pays differently.

We no longer needed punitive measures as a whole as the community responded

better to a lower key approach.

Third we have had to change because of the increasing amounts of co-pays

and

the burden they cause.

.. We attempt to collect co-pays at time of service however, we have

eliminated the heavy handed techniques of requiring it or having

threatening

signs.

.. We give each client a handout at the time of evaluation that

explains our billing procedures including co-pays but also lets them know

that we are willing to work with them on options and that we hope that

payment does not effect getting them the care they need. The language on

this handout is matter of fact - no threats and more positive towards how

important it is that they get treatment without worrying so much about

payments.

.. We offer the option of paying co-pays at the time of service or

paying co-pays per week. Our seniors on Medicare Advantage programs that

have reasonable co-pays of $10 - 15 tend to like to pay weekly especially

if

they are being seen 3X/week. It saves check fees for those still using

checks as well.

.. We do have an option of rolling the co-pays into the balance owed

and doing a payment plan. We start at $50.00 per month and only apply

interest to those accounts that are not paid on time (very rare in our

community). We have read and re-read our insurance contracts and none

specify that the co-pays have to be collected at the time of service. They

do specify that they should not be waived (see later about that option). We

have never been questioned on this so we continue to offer this. Generally

we offer only if we see that someone is hesitating about coming back to PT

because of the co-pay. We do the same with high deductibles and consider

this process the same as handling a client with a high deductible owed. I

would say that we do this in 10% of our co-pay cases.

.. We have very few cases that go to collections but the co-pays owed

become outstanding balances just like everything else so we have had cases

go to collections which involved unpaid co-pays as part of the unpaid

balance. Again it has been very few (yes we know we are lucky!). Since we

have so few go to collections, we have been slow in turning them over. We

make a few attempts to contact the client by mail, then by phone and record

each effort in the chart. I would say that it is at least 3 months after

their last visit that it goes to collections.

.. We do have a process by which we can legitimately waive co-pays

and that is okay with insurances. We have not had to use it yet but it is

available. In the case of severe financial hardship, we would ask the

client to fill out a financial statement and keep a copy in their record.

We have a form that each of us would sign officially stating the co-pay is

waived and why. In addition, we have a full policy written explaining the

process. These elements meet the requirements we have seen and have been

educated on as to how co-pays can be waived: have clear policy and

procedure, use a financial statement and have a copy in the record and fill

out a form stating why the co-pay is waived. We know that we cannot use

this process except in very rare cases but it is good that we have it

available.

.. We have staff that is excellent at collecting co-pays and in fact

we have removed it from quality improvement process because we were

consistently in the high 90% at collecting co-pays. I do recommend that

clinics do their own quality improvement process to make sure that staff id

attempting to collect, especially in larger clinics where missed co-pays

can

add up fast.

Take all of this with keeping in mind that our procedures are quite

different from many clinics. We don't have any specific research that our

procedures, which take away the heavy handedness of requesting co-pays at

the time of service or threatening to pull service if co-pays are not paid,

works but we do know that we get paid regularly and 90% at the time of

service. Anecdotally, we know that many find the low key approach more

friendly and helpful to them. I think ultimately you have to know your

community and know what will work best. Business-wise, it is still strongly

recommended that co-pays are collected at time of service and I am sure

that

some will discuss the importance of paying at the time of service to show

the reason for the co-pay - shared responsibility. I don't disagree with

that but also say that I have not ever seen where a person understanding

the

shared responsibility of co-pays ever acted or reacted different in

therapy.

To them it is just another payment that has to be made. We have just tried

to reduce the punitive techniques and turn it into a positive experience.

Clients know that their payment counts and helps us stay in business, it is

just down in a more low key way. We would like to think that our methods

would allow improved co-pay collection in any community but again, we have

no proof of this. We would like to think that we do so well at collecting

co-pays and have so few cases go to collections because of our procedures

but again we have no proof. What we do have is most co-pays collected at

time of service and few cases going to collections which ultimately is the

important measure no matter what methods are used.

Hope that helps!

M. Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

<mailto:_thowell@..._ (mailto:thowell@...) >

_thowell@..._ (mailto:thowell@...)

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

From: _PTManager _ (mailto:PTManager )

[mailto:_PTManager _ (mailto:PTManager ) ] On

Behalf

Of _mlavcavitt@..._ (mailto:mlavcavitt@...)

Sent: Tuesday, April 26, 2011 6:45 AM

To: _PTManager _ (mailto:PTManager )

Subject: Time of Service Payments

Hello to all,

I'm interested in getting feedback from the list regarding processes used

to successfully collect time of service payments from patients? Do you

inform patients before they are scheduled what their expected out of pocket

will

be? Do you reschedule patients if they are unable to pay their copay,

coinsurance or deductible at the time of service? If yes, do patients

return

when they are able to pay? Do you set up monthly payment plans for

patients who cannot pay at the time of service? If yes, what percentage do

you

attempt to collect each month? Do you charge interest on uncollected

account

balances? Do you turn patients over to collections? If yes, after how

many days past due? Any input is greatly appreciated.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guilbeau Road, Suite A

Lafayette, LA 70506

[Non-text portions of this message have been removed]

[Non-text portions of this message have been removed]

Link to comment
Share on other sites

Guest guest

Dear ,

Thank you so much for the wealth of information. I have a very special

client that would prefer not to implement punitive measures for patients that

do not or are not able to pay at the time of service. We are looking for

any and all options to assist him in this process as he is having

difficulties collecting from patients at the TOS. You have given me a number

of

ideas to assist him. For this, I am grateful.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guidry Street, Suite A

Lafayette, LA 70506

In a message dated 4/26/2011 12:53:53 P.M. Central Daylight Time,

thowell@... writes:

Hi Vickie,

First of all the one thing that helped us collect co-pays more regularly is

when we finally got a credit card/merchant services machine. We now balance

the fees with improved co-pay management and improved cash flow.

Second, a lot has to do with where your clinic is located and the make-up

of

the surrounding community. After we moved our clinic in 2004 (thanks to a

POPTS situation), we found that we could process our co-pays differently.

We no longer needed punitive measures as a whole as the community responded

better to a lower key approach.

Third we have had to change because of the increasing amounts of co-pays

and

the burden they cause.

.. We attempt to collect co-pays at time of service however, we have

eliminated the heavy handed techniques of requiring it or having

threatening

signs.

.. We give each client a handout at the time of evaluation that

explains our billing procedures including co-pays but also lets them know

that we are willing to work with them on options and that we hope that

payment does not effect getting them the care they need. The language on

this handout is matter of fact - no threats and more positive towards how

important it is that they get treatment without worrying so much about

payments.

.. We offer the option of paying co-pays at the time of service or

paying co-pays per week. Our seniors on Medicare Advantage programs that

have reasonable co-pays of $10 - 15 tend to like to pay weekly especially

if

they are being seen 3X/week. It saves check fees for those still using

checks as well.

.. We do have an option of rolling the co-pays into the balance owed

and doing a payment plan. We start at $50.00 per month and only apply

interest to those accounts that are not paid on time (very rare in our

community). We have read and re-read our insurance contracts and none

specify that the co-pays have to be collected at the time of service. They

do specify that they should not be waived (see later about that option). We

have never been questioned on this so we continue to offer this. Generally

we offer only if we see that someone is hesitating about coming back to PT

because of the co-pay. We do the same with high deductibles and consider

this process the same as handling a client with a high deductible owed. I

would say that we do this in 10% of our co-pay cases.

.. We have very few cases that go to collections but the co-pays owed

become outstanding balances just like everything else so we have had cases

go to collections which involved unpaid co-pays as part of the unpaid

balance. Again it has been very few (yes we know we are lucky!). Since we

have so few go to collections, we have been slow in turning them over. We

make a few attempts to contact the client by mail, then by phone and record

each effort in the chart. I would say that it is at least 3 months after

their last visit that it goes to collections.

.. We do have a process by which we can legitimately waive co-pays

and that is okay with insurances. We have not had to use it yet but it is

available. In the case of severe financial hardship, we would ask the

client to fill out a financial statement and keep a copy in their record.

We have a form that each of us would sign officially stating the co-pay is

waived and why. In addition, we have a full policy written explaining the

process. These elements meet the requirements we have seen and have been

educated on as to how co-pays can be waived: have clear policy and

procedure, use a financial statement and have a copy in the record and fill

out a form stating why the co-pay is waived. We know that we cannot use

this process except in very rare cases but it is good that we have it

available.

.. We have staff that is excellent at collecting co-pays and in fact

we have removed it from quality improvement process because we were

consistently in the high 90% at collecting co-pays. I do recommend that

clinics do their own quality improvement process to make sure that staff id

attempting to collect, especially in larger clinics where missed co-pays

can

add up fast.

Take all of this with keeping in mind that our procedures are quite

different from many clinics. We don't have any specific research that our

procedures, which take away the heavy handedness of requesting co-pays at

the time of service or threatening to pull service if co-pays are not paid,

works but we do know that we get paid regularly and 90% at the time of

service. Anecdotally, we know that many find the low key approach more

friendly and helpful to them. I think ultimately you have to know your

community and know what will work best. Business-wise, it is still strongly

recommended that co-pays are collected at time of service and I am sure

that

some will discuss the importance of paying at the time of service to show

the reason for the co-pay - shared responsibility. I don't disagree with

that but also say that I have not ever seen where a person understanding

the

shared responsibility of co-pays ever acted or reacted different in

therapy.

To them it is just another payment that has to be made. We have just tried

to reduce the punitive techniques and turn it into a positive experience.

Clients know that their payment counts and helps us stay in business, it is

just down in a more low key way. We would like to think that our methods

would allow improved co-pay collection in any community but again, we have

no proof of this. We would like to think that we do so well at collecting

co-pays and have so few cases go to collections because of our procedures

but again we have no proof. What we do have is most co-pays collected at

time of service and few cases going to collections which ultimately is the

important measure no matter what methods are used.

Hope that helps!

M. Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

<mailto:_thowell@..._ (mailto:thowell@...) >

_thowell@..._ (mailto:thowell@...)

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

From: _PTManager _ (mailto:PTManager )

[mailto:_PTManager _ (mailto:PTManager ) ] On

Behalf

Of _mlavcavitt@..._ (mailto:mlavcavitt@...)

Sent: Tuesday, April 26, 2011 6:45 AM

To: _PTManager _ (mailto:PTManager )

Subject: Time of Service Payments

Hello to all,

I'm interested in getting feedback from the list regarding processes used

to successfully collect time of service payments from patients? Do you

inform patients before they are scheduled what their expected out of pocket

will

be? Do you reschedule patients if they are unable to pay their copay,

coinsurance or deductible at the time of service? If yes, do patients

return

when they are able to pay? Do you set up monthly payment plans for

patients who cannot pay at the time of service? If yes, what percentage do

you

attempt to collect each month? Do you charge interest on uncollected

account

balances? Do you turn patients over to collections? If yes, after how

many days past due? Any input is greatly appreciated.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guilbeau Road, Suite A

Lafayette, LA 70506

[Non-text portions of this message have been removed]

[Non-text portions of this message have been removed]

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...