Revenue Cycle

Q: We’re a physician practice. Do you have any guidelines on how to improve the skills of our in-house collectors? Do you have to bill within 24 hours or can it be three days between the tests and you need to use the combined codes?

Patient Financial Services Weekly Advisor, July 15, 2005

A: You may feel that your own billing staff can handle delinquent accounts better than an agency can. While that may be true to some extent, there comes a point when pursuing old balances doesn't make sense for your staff. Moving "hard collections" to an agency frees your staff to focus their talents on effective insurance billing, up-front patient collections, and "routine" follow-up.

Of course, that doesn't mean you should allow your billers to neglect pursuing patient balances. Set up clear policies and procedures for collecting what patients owe you, including:

  • clear, detailed account statements

  • balance-due reminders on statements

  • automatic collection-letter series

  • telephone collection strategy

  • alternate payment systems such as credit cards, monthly payments, or balance financing through a financial institution

    But despite your staffers' best efforts, some patients simply neglect or refuse to meet their obligations. When a balance ages beyond 90 to 120 days without sufficient payment (or a promise to make routine payments), consider it eligible for charging off to a collection agency.

    Give only trusted senior staffer(s)-perhaps your manager or billing supervisor-the authority to send patient accounts to a collection agency. Make sure they understand how tough you want them to be. Further, insist upon reviewing every account slated for collections. Have your biller prepare a one-page summary showing the balance, efforts to collect, and the patient's responses.

    This way, if you see a delinquent account for a patient whose balance you promised to write off, you can veto the charge-off and avoid embarrassment. Or if you see an angry or dissatisfied patient's account, you may avoid a lawsuit by keeping it out of a collection agency.

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