With rising operating costs, staying profitable can be a constant challenge in your medical practice. In this competitive landscape, it is not enough to be just a phenomenal physician. To maintain (or grow) profitability, we have five challenges for you that we’ll feature over the next few months. Here are the first of five important policies to introduce to your medical practice or facility.
Success can be made by learning from the mistakes of others. Mistakes can cost a significant amount of money, stress and in some cases, causing the shut down of one's medical practice or facility. In addition to medical practice start-ups, billing audits, and physician credentialing, TTG Healthcare Advisors specialize in creating profitable medical practices. TTG engages with their clients to help avoid common pitfalls and establish you, and your medical practice, for the success you deserve.
Challenge #1: Understand the value of your patient collections.
TTG pulled data from over 50 medical practices and surgery centers that varied in size, location and specialty. In 2013, patient responsibility was 5.25% of the total income. In 2018, we are trending at 11.2%. In 2019, we expect up to 13%. This amount is largely uncollected income, and missed opportunities, for your practice.
Based on our experience and study, please see below:
If the patient leaves your practice or facility, without paying, there is a very small likelihood that 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 medical payments down after the service is provided.
Implement the following into your practice, immediately (or call us for help):
1. Deductible collections: designate a team member to check insurance benefits and the deductible amount 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 the service. Or, set up a payment plan where 50% is collected up front, and the balance is collected 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 the patient is responsibility for. In most cases, it is an estimate but, aim to collect 75% of this amount up front.
3. Past due collections: have the check-in team request patient past due balances when they check in, and collect for past due during this time.
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 are not enforcing this, please do. It’s a contractual obligation for most insurance companies and a very fair expectation.
You work with your patients to improve their health. We work with you to improve your practice health, your profitability, and your quality of life.
As Healthcare Consultants, TTG's mission is to educate healthcare providers and facilities about common pitfalls of running your own medical practice or surgical center. Visit our website at: ttghealthcareadvisors.com to download helpful tools or, contact us at 877-884-3350 to review your processes and work with your team.