Accounts receivable and collection percentages are a subject that we hear about frequently. Every doctor has a different idea about what a good collection percentage is as well as how to collect money for services rendered.
For example, I have talked to many doctors who feel obligated to let patients/clients go without paying. They feel guilty about trying to collect from someone if they feel that the person is in a financial hardship.
While this is quite altruistic, it is very short-term thinking. These doctors must also understand that they can’t continue to provide help to their patients/clients if they can’t afford to keep the doors of their practice open. Another fact that is not commonly known is that failing to pursue a bill and persevere in asking for payment can actually have a negative effect on the patient/client’s self-respect. People expect to be billed, even when they complain. While it can be uncomfortable to deal with objections, realize you are making it possible to help many more patients over the years – and that is worth mentioning to them, as well.
Failing to insist on payment for services rendered can also lower your own esteem, making it harder to collect the next time. If you provide a service, you should be compensated for it. Period. Unless you go into a situation knowing in advance that it is going to be a charity case – and there is certainly room for that in any practice as long as it is planned for – you should always insist on being paid for rendering that service.
Of course, this is great in theory, but being able to actually collect all monies owed is another story and requires good group coordination and effort. If you and your staff are trained on how to do this from initial contact through patient discharge, including having the proper policies in place with your staff and patients/clients, your chances of collecting at the time of treatment go up exponentially. We believe that you should be collecting 98% or better of what you are producing, minus insurance adjustments. If you are collecting less than 98%, you are losing net income out of your own pocket.
Here are a few other tips that may help you when dealing with the uncomfortable situation of a patient/client who is saying they cannot make payment:
- Believe it or not, smiling is one of the strongest tools you have to deal with uncomfortable topics. Frowning or looking worried can have a subtle but negative effect on the conversation. Smiling naturally in a friendly manner when it is appropriate to do so is the best method.
- Speak confidently, concisely, and firmly. Never apologize for your prices.
- Listen carefully, but also use silence to control the conversation. One of the most powerful things you can do in a conversation is state your piece…and then shut it. The silence will become uncomfortable for the person, and they will often try to fill it by giving you reasons why they cannot pay. Acknowledge those, and continue to gently insist that a solution is found to make payment.
- Stay calm, even if the patient/client gets upset. Your emotions should not give the person any excuse to take offense or try to wiggle around the main topic of the conversation.
- Focus on one thing only – the patient/client – when making the calls to collect. Do not multi-task, but instead, concentrate on the person in front of you. This makes them feel important to your practice (which they are), and shows a level of care that can make paying easier to face.
By using these tips, you can gain better control of your collections percentages and thereby the level of care you can provide to future patients/clients. Any staff who deal with collections in your practice should be drilled on a regular basis in how to handle objections, present payment requests, and demonstrate a genuine, caring attitude. Whether you are asking in person before the person leaves, or trying to collect over phone, text or email, these same points apply.
Staff normally dislike roleplaying, and it is too easy to avoid in the busy week. But the reason for the distaste is often only a few simple (and very easy to correct) mistakes on the past of the executive doing the drilling:
- Only correct one thing at a time. Letting people have wins is one of the most overlooked, and therefore most important parts of drilling. When your staff first start out practicing objections-handling, they may make many errors all at once. THAT’S OKAY. It’s a drill, not a test. Simply pause the drill, correct just one thing, and have them continue drilling until that one thing is handled. Then take up the next error.
2. Failing to balance criticism with praise. When staff do something right during a drill, pause and let them know. This reinforces what you want, and in fact can often be more powerful than any negative criticism you might offer. In other words, push the hardest on the thing you want more of.
Let me explain. If at the end of your fiscal year you have enough money to pay for everything, i.e., all of your overhead is covered, such as your staff salaries, your mortgage/lease, equipment payments, taxes, etc., any lost income then becomes your own lost personal net income. For example, if you were collecting an average of 93% (5% lower than what should be your standard) with an annual gross income of $650,000.00 ($55k per month), this would equate to a loss of $32,500.00 per year. Over ten years this amounts to a staggering $325,000.00! And that is essentially straight out of your own pocket. This is the equivalent of you working one year or more out of every ten years for free. Many doctors we survey think that “a few percent here or there isn’t that significant.” I hope the above numbers disabuse you of that idea.
With the above in mind, is it now worth it for you to spend the time to train your receptionist and/or collection/finance person on collecting properly?
Here are some tips on things that you can do to increase your collection percentages.
When a new patient/client initially calls to make an appointment, the receptionist should keep it as simple as possible for the patient to arrive. So, you want to schedule them in as soon as possible. You want their first impression to be that they feel well serviced. The new patient/client should be informed to arrive early enough to fill out paperwork, so the appointment can happen on time. Payment terms and conditions should not be discussed on the phone with them. You want to make it as easy as possible for the new patient/client to come into the office and not be put off by anything during the initial contact. When they get into the office, you can then go over your financial policies. You should ask them to bring any insurance information that they have should insurance be relevant to the potential treatment. This should include the name of the company, their policy number, what is covered, what their deductible is, etc. Do not worry about having to get into the details of this over the phone and don’t make the patient feel harassed by this. You don’t want to turn the patient off before they even arrive, or they may not arrive. You want the patient to feel friendly and comfortable about coming into the office, but at the same time, you want them to bring any relevant data that they can.
When They Arrive
As soon as the new patient/client comes through the door, they need to be greeted warmly by the receptionist. The receptionist should then supply the new arrival with the necessary forms to fill out. Included should be a form covering your specific payment requirements indicating that payment is due at the time of treatment and/or your insurance agreements and arrangements. If insurance is involved, the form should include a place to provide what insurance they have, how much is covered, what the deductible is and, most importantly, that they will be expected to pay the copay, deductible or anything not covered by insurance at the time of treatment. They should also be told that, unless otherwise agreed upon, you don’t offer billing but will gladly accept cash and most major credit cards. Let them know if you offer financing through companies such as Care Credit, and if they feel that they will require such financial assistance, make sure they meet right away with the person in your office who handles these matters. If you don’t take care of it on the spot, you are likely to be left with a collection problem on this account. Make sure that you require their signature on this form that signifies that they have read, understood and will comply with the financial policy of your office
Once They Have Received Treatment
Validate your patient/client for the good decision that they made to confront and handle the problem that they came to you with. Let them know that they did the right thing and that the investment they made was a good one. Follow up the first treatment with a quality control call, ideally from the doctor, to make sure all went well.
As treatment continues, make sure that everyone in the office continues to reinforce the good decision the patient/client made, and make the patient/client feel welcome in the office.
If you do these things, you will see a turnaround in your collection percentages, and you will see your net income go up.
If you feel you would benefit from a one on one consultation on any practice management questions or concerns, please fill out the form on this page and we would be more than willing to assist you.