Guest guest Posted April 26, 2011 Report Share Posted April 26, 2011 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2011 Report Share Posted April 26, 2011 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2011 Report Share Posted April 26, 2011 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] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2011 Report Share Posted April 26, 2011 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] Quote Link to comment Share on other sites More sharing options...
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