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Four key methods for private practices to mitigate outstanding patient balances

High deductible insurance plans are becoming increasingly common in health care, and have patients taking on more of the financial responsibility. As out-of-pocket costs rise, the probability of having an outstanding balance left on the table increases.

Practices that are either struggling to get reimbursed or simply wish to improve their fiscal health need to take a hard look at their collection efforts. The following are four fundamental strategies for improving collections in mental health.

1. Impart the right expectations to staff

The industry trend in the past decade has more practices responding to consumer interests, according to an article published by HealthcareDive. While this has meant that many practices have designed their clinical settings and business strategies around the patient’s choice for care delivery in mind, billing, too, must operate with similar retail-minded principles. Asking an insurance provider for money will always feel less morally precarious than a patient who may be suffering, but front staff must have collections baked into their protocols. Additional training, scripted materials, or role-playing may play an essential part in broaching the subject matter with compassion.

2. Verify eligibility

When possible, providers must seize opportunities to stay ahead of the revenue cycle process. Communicating with payer organizations will go a long way in managing any complications before they emerge later on. A current common practice is for schedulers to contact the patient’s insurance provider to understand:

  • What kind of services are covered
  • What kind of deductibles exists
  • How much of said deductible the patient has already covered
  • What kind of copay the patient will need to settle at the time of service

Appointment reminders that include some kind of summary for what the patient might be responsible for at the time of treatment have been known to improve patient readiness for tendering payment and improve collections in mental health. It is also a good opportunity to find out if the patient has an HSA or flex spending account. Many modern EHR systems feature integrated billing systems that can offer insight.

3. Provide options that align with the patient’s ability to pay

Drawing a hard line in policies and procedures regarding payment is likely to invite outstanding balances instead of eliminate them. Practices today are finding more success in establishing payment plans and offering sliding scale models. Patients that are unable to pay off their entire responsibility of the bill, for example, are usually able to at least pay some portion. Allowing for a full collection over a period of six to twelve months may help your practice collect on something. Large outstanding balances are less likely to be received as time passes, and bad debt is often the result. In cases where the patient’s need for care is dire, sliding scale payment models will help cover expenses while maintaining commitment to the practice’s mission.

4. Make payment easy

Easy payment systems create a greater likelihood to receive reimbursement. The ability to accept credit cards at the practice is strongly recommended, though some practices go as far as offer online payment through a patient portal or through web-based services like PayPal. Automatic billing is also a possibility, though it requires a signed patient consent form to set up. In any case, enabling multiple avenues of payment and making the process as easy and seamless as possible is an effective way to see immediate returns.

There may be no guaranteed formula for 100% successful collections in mental health, but if practices observe a few basic protocols, they should expect to see significant improvement. The tides of the healthcare industry have the financial responsibility tilting more and more toward the patient, but if practices set the right expectations and demonstrate a willingness to work with an individual patient’s circumstances, the wheels of care will continue to turn.