Read below for the first of five important policies toward creating a profitable medical practice. Stay tuned for the rest of the policies to be shared over the course of the coming months. Success is largely due to learning from the mistakes of yourself and others. These mistakes can cost a significant amount of money, stress, and in some cases, actually result in the shutting down of the facility or medical practice.
It is not enough to be a phenomenal Physician. To maintain (or grow) profitability, we have five challenges for you that we’ll feature over the upcoming months.
Challenge #1: Understand the value of your patient collections.
According to data pulled from 50 practices and surgery centers of various sizes, locations, and specialties:
In 2013, patient responsibility was 5.25% of the total income. In 2022, we anticipate over 10% of your total collections is patient responsibility. If you should collect $1,000,000.00 in collections, over $100,000.00 is from the patient responsibility portion.
This amount is largely uncollected income and missed opportunities for you.
If the patient leaves your practice or facility, without paying, there is a very small likelihood you will receive that payment. It’s not due to sheer negligence from the patient. Patient statements are confusing, often inconsistent, and most billing teams do not have the capacity to chase these payments down after the service is provided.
Implement the following into your practice, immediately:
1: Deductible Collections: designate a team member to check insurance benefits, deductible amounts available and used. Educate the patient on the status of their deductible and the amount due for services. If it’s over $100, we recommend calling the patient in advance to make sure they are aware. This applies to office, surgical and facility services. Collect this deductible amount before services are offered. Or, set up a payment plan where 50% is collected up front and the balance at the post op/follow up visit.
2: Co-Insurance Collections: most plans do not cover 100% of services. Calculate an estimate of what amount will be due that is patient responsibility. In most cases, it is an estimate but, aim to collect 75% of this amount up front.
3: Past Due Collections: ask the check in team to check for patient past due balances when they check in and collect for past due at the time of service.
4: Patient Co-Pays: Most practices are collecting co-pays. The amount collected may not always be the right amount but copays are not the reason for the collection shortage. If you’re one of the few that aren’t enforcing this, please do. It’s a contractual obligation for most insurance companies and a very fair expectation.