Most of us have been taught to shy away from talking about money. We are told it is impolite, embarrassing, and downright taboo. With that kind of reinforcement, it's not surprising that the money conversation is often neglected at the front desk. With a patient standing right there, it can feel awkward to bring up the very thing we have been taught to avoid, and when that happens, a primary source of income slips through the cracks.
It may not ever feel perfectly comfortable to discuss finances with patients, but here are some simple strategies you can employ to ease the process along.
#1 Be Prepared
You won't collect it if you don't know what you are asking for. Before the patient arrives for the appointment, take the time to verify eligibility. Make sure you have their current insurance information, know the benefit details, and know if you are in or out-of-network with the plan. Verify if there is a flat rate copay, or if instead there is a deductible or co-insurance. When there is a deductible, if the payer provides realtime access to this information, you can find out if it has been met already. If it has not, determine how much remains. With deductibles and co-insurance, it is helpful to know each plan's allowed amounts per code so that you can calculate the amount due at the time of service. Consider creating a spreadsheet showing the allowed amounts per payer, so that you can accurately calculate the amount due rather than waiting for the EOB/ERA. Most payers allow providers to collect for deductibles and co-insurance at the time of service. However, as some do not, it is important to verify your payer contracts prior to asking patients to pay these balances.
If you work in a practice that treats multiple members of the same family, such as a pediatrician's office, you can also prepare yourself by checking balances across all accounts prior to the appointment. That way, if just one member comes in for an appointment, you can collect anything owed by the family as a whole.
Each day, it is also a good practice to look over the following day's appointments and check for any patients who have large balances due. By doing this, you can be prepared and have a plan in place for how you will handle it when they arrive.
#2 Offer Options
In order to facilitate collecting payments at the time of service, it is important to offer as many payment options as possible. In addition accepting cash and checks, offices should be set up to accept all major credit and debit cards, both in person and over the phone. Some patients prefer to keep a credit card on file for ease of paying bills. If you do this however, you must be sure to research and follow the appropriate security measures to comply with HIPAA and PCI DSS standards. At a minimum, if kept as a hard copy, this information should be stored in a locked area, with access limited to authorized staff. If stored electronically, it needs to be securely encrypted. Although there are advantages to storing credit card information, it presents a vulnerability in terms of potential security breaches. Therefore, the decision to keep cards on file should not be made lightly.
As high deductible plans become more common, it is easy for patients to accumulate a significant balance in a short period of time. In order to facilitate a patient consistently getting the care they need, payment plans can be a viable option. It's a good idea to collect an initial deposit, as well as complete a signed agreement between the office and the patient that outlines a schedule of payment dates and amounts. Having this to reference can help a patient stay on track, rather than just letting them tell you they'll "send a payment soon" and then you never see the money.
Another way to help a patient get current is to have them pay that day's balance in full, and offer a payment plan option for only the past due balance.
Lastly, for someone who says they will send a check, go ahead and give them a stamped, self-addressed envelope and a printed invoice. They are more likely to remember to mail it if they walk out the door with this in their hand.
#3 Develop Rapport
Sometimes the pace at the front desk is too busy to have time to chat with patients for long. You can still develop a good rapport despite a brief interaction. Taking a few minutes to get to know a patient and have a friendly exchange can go a long way toward helping you get paid. A hostile or blaming attitude coming from front desk staff deters a patient from bringing up the subject of their overdue balance. Even if the payment due is large, showing understanding for where the patient is at, and working with them to create a reasonable plan will help you get paid and retain a patient.
#4 Consider Your Timing
Timing your conversations correctly can impact how well you collect payments at the front desk. Starting when a patient calls to schedule an appointment, an opportunity presents itself to remind them of any balance due and ask them to bring a payment to the appointment. Planting the seed before they are even in the office prepares them and does not leave them caught off guard when you ask for payment in person. Prior to them coming in is also the time to discuss any potential financial hardships and formulate a plan with the patient.
Once they are at the office, if a patient has a set copay, collecting it during the check-in process is preferable. That way, if they are on a tight timeline and need to run out the door after the appointment, you will still have your money.
If the payment will be based on how the visit is coded, such as with a deductible or coinsurance, mentioning it during check-in so they know it is coming, and collecting it during check-out can work well. If a patient needs to delay payment until the next visit, make sure to schedule the follow-up appointment then and there, rather than waiting for them to call. Of course, they may still cancel, but if an appointment is on the calendar before they leave, you are more likely to see them again and collect your payment.
#5 Communicate Effectively
The way you communicate to a patient around money has an impact. Communication includes your body language as well as your words. Making eye contact, and speaking in a friendly tone of voice can make the patient feel at ease. Asking open-ended questions will get you much further than those that only require a one word answer. Communicate in ways that will facilitate engagement and action on the part of the patient.
- Instead of asking: Do you want to make a payment?
- Try asking: How would you like to pay for this balance today?
- Instead of asking: Did you know you have an outstanding balance?
- Try stating: I see you have a balance due. You can either pay that in full today, or if it would be easier for you, we can discuss splitting it into payments. What works best for you?
In each instance, the former requires only a yes or no answer, whereas the latter opens the door to a conversation.
Clear communication is also essential when it comes to the written word. It is important to have patients sign a financial policy prior to receiving services. You should go over the agreement with them at their first appointment and make sure they understand the details and have a chance to ask questions. If the future, if they question your request for payment, you can refer them back to the policy that they signed and agreed to.
Small shifts in how you interact with patients at the front desk can increase your ability to collect payments at the time of service.
Being prepared for many possible scenarios and having a plan in place for how you will handle them is key. Although a literal script may or may not be necessary, knowing your talking points and being direct, yet compassionate will yield positive results.