David,
We do use a collection agency, but the decision to do so is not always a "slam-dunk". The actual amount we collect through this route is miniscule; the agency rarely collects much money, and they keep a sizable percentage of what they bring in.
The downside is the ill-will generated by sending people to collections. You might question why I would care about the feelings of the deadbeats. Frankly, I don't, but I do care about the income from their procedures. So there is a calculation as to whether we want to potentially lose future business (e.g. income from colonoscopies) over a $30 co-pay.
We don't use a collection agency to bring in any significant income; we use it as a "consequence" for the deadbeats, and so that we aren't completely turned into doormats.
The
credit card solution described here has a lot of appeal. One missing piece may now be provided by Updox's ability to securely store card numbers. The other missing piece (as I see it) is being able to reliably know what the patient's current status is with regard to co-pays and deductibles. In other words, if I could reliably know what the patient will owe, after insurance, then I would feel comfortable telling them we will charge that amount to their card. Right now I can't get that information very reliably.
