Home Forums Discussions Amazing Charts Practice Management Small Practice: Patient Deductible Collection

We use ACPM for billing. I know there is a function within the program that allows us to keep a credit card on file for the patient. It shows up in the View/Change screen. However, I can't find ANYWHERE in ACPM where I would store a CC.
We have a problem in this office with patient's completely walking away from their deductibles, in fact, my aging report is over $6K in patient owed accounts.
We are contemplating enforcing a Credit Card on File policy and need someplace to store said information.
I would love some feedback if any other practices have tried this method, either in ACPM or some other way.

Thanks.

We do not us PM. We considered doing CCOF in our office but, we didnt. We do it on a case by case basis. Below is our form for Credit Card Payments taken over the phone. I have used this before for patients that did want us to keep their credit card on file and take out 1 payment for several months in a row. I had them answer the questions and then sign the bottom. The form was then scanned into their chart and I kept a special EXCEL spread sheet with the information and contract. This has worked out well. I did tell the patients that if for any reason the card was declined I would call them and make other arrangements. That only happened once and the patient was very grateful and paid her balance off earlier than planned.
CREDIT CARD OVER THE PHONE PAYMENT FORM

PATIENT ID:
NAME AS IT IS ON CC:
TYPE OF CC:
CREDIT CARD #:
EXP. DATE:
PAYMENT AMOUNT:
CALLER:
TAKEN BY:
DATE:
PROCESSED DATE & TIME:
PROCESSED BY:
Does patient want a copy of the receipt sent to them by the Portal?
Does patient want to set up monthly payment plan?

What date in the month does payment need to come out?
From to Healthy Concepts will charge the CC above the amount of $ at the above designated time of the month for the months of .

Patient Signature: Date:
Employee Signature:
Allison

You guys are really lucky. Some of our patients do not acknowledge they have deductible and do not want to pay copays especially if they come back shortly after the first visit and front desk staff get to hear not so nice things every day. Do you have any tips on how to get better at collecting funds that are patient responsibility. Above info is very helpful but when we tried it, some patients got upset and one patient actually filed a complaint (unauthorized charges)with the credit card company.

We are lucky that we have some great patients and it is really like a family affair when they come in. I do a lot of DEDUCTIBLE reminding. At the beginning of the year. like now, I remind them to check on their deductibles and that they will be receiving a bill for it and they will owe it. When I verify the insurance I include the deductible amount in the billing area in AC. As it changes I change it. Each visit I remind them that if they have a co-insurance that may be due so look for a statement. They are responsible for what their insurance does not cover.
All of this takes a lot of time and energy but, so far we have only had 4 patients that have not paid and they are no longer our patients. We did not have to discharge them. I just called and mailed letters and sent portal messages and they stopped coming. I made sure to keep within the collection laws.
Allison

Finally someone else wants to talk about this topic! I have been fighting with this for a long time. Since 2009 we have about 60K outstanding (some of this does include work comp and MVA stuff so the number is going to be less). People walk away from deductibles. People when emailed last year said I can't believe you are still trying to collect, I figured you would forget about it and let it go.

When I first started my practice, I was just so scared of not having patients and people getting pissed off. We never used a collection agency. Last year we have a bunch of money outstanding too. Now I don't care if we piss off patients and they go somewhere else for their ortho/sports med care, they can go there, give them the headache and learn that they won't get my care anywhere else.

So I have now started collecting 150 bucks towards their deductible up front before the girls bring them back to the rooms. We tell them that we are going to collect the copay and 150 towards the deductible up front when new patients make appointments or patients who haven't been here in a long time make appointments. We had one girl who came in and was upset about it, we simply let her know that we have been chasing money every year from people who stiff us and we are not saying she would, but this is our policy. ANother kid kept saying he understands what deductible is but his insurance always pays everything. We won't budge on our policy now. If you want to be seen, you pay, you don't want to be seen, you are welcome to not be seen and we will cancel your appt. So far since January 3rd, only those two issues but both ended up paying and being seen and said they were happy with the visits.

At least we figure this way, instead of chasing 220 per visit we are only chasing 70 of it. That way they also don't think they owe so much later. I will keep you all posted on how this goes.

As for the credit card thing, there is a dermatologist in NY who wrote a great article in the washington post or NY times about how he switched over. He said he lost a few patients, but the amount that he collected without issues was totally worth it.

We also collect up front a smaller amount than most insurance plans pay. It seems like nobody really complains about it. There are times we have to give the patient a refund.

In our new patient packet, that every patient signs before they are allowed to see the doctor, there is a line that indicates that they are responsible for all charges not covered by insurance, including, copays, coinsurance, deductibles and denied claims due to termed policies (in the event someones' insurance terms overnight - it's happened before, so we make it a blanket rule in the paperwork).
It also states that if they don't pay their portion within a reasonable amount of time (30 days) then we can bill them at 1% of the balance per month. We also have it written in there that if we have to obtain legal services to collect the debt that they are responsible for those as well.
Surprisingly, people don't read the fine print; they blindly sign it and act shocked when I send them to the Collections agency after 120 days.

My newest attempt at getting ahead of the patient's billing is to make an Excel spreadsheet of all of our charges and the allowables for each insurer. So far I have the major payers all lined up.
Before the patient comes in, I log in to the insurance website, see if they've met their deductible and if they haven't, I collect the whole thing at the time of service. If they don't like it or want to complain, I offer them another appointment on a day when they'll be able to pay their portion or cancel them altogether if they say they can't afford it. Then comes the explanation that they'd still owe it whether they pay up front or after, and since I'd rather not chase them...
It seems like more work, but it should save money on the back end with mailing out statement after statement and attorney fees.
Of course, this method really only works effectively for patients with a single commercial insurer or Medicare with no secondary. But I'm interested to see how efficient it will be.

TCosta, are you willing to share your paperwork? i like your approach. we do log in before and know their deductible.

We have to work harder and smarter now to collect the payments but, in the end it is worth it. Every office is different so , whatever works for your offfice. I too am glad that we are talking about this. It is great to see how others are doing collections.

Great suggestions. We started collecting up front last year and some patients have a FIT. They get mean with the front desk staff, throw a fit in front of other patients, blame us, "it is all about money", "you are acting like a bank", "my other doctors do not do this". What really bothers me is when the insurance does not pay for certain service, the insurance's customer service sometimes tells them that the doctor did not bill it correctly or gave "wrong code". At the beginning of the year and with high deductible plans, it becomes very challenging.

We have not gone so far as checking the insurance web site for each patient before they arrive. However, we ask them if they have met their deductible, and if not, collect in full. Just look them in the eye and ask if they would like to pay what they owe with cash check or card. Then be quiet and wait for them to respond. Sometimes they don't know their deductible, and we say why don't you put 150 down and we will bill the rest if needed. We also send our billing company our schedule, and they respond with what everyone owes each day. "Sir, you have a 35 dollar co-pay today and with the 70 dollars you owe from last visit, your total is $105. Would you like to pay that with cash, check, or card." "You cannot pay today, well why don't we reschedule for after you get paid."

There is a small stack of unpaid accounts each month. Under 100 they don't go to collections. Over this amount, they get a letter from the manager that they need to pay or it will go to collections, and that our policy is to discharge patients who will not pay for our services. They either pay or they are gone. You don't want those people anyway.

As a small office we too collect the deductible at the time of service. We know the allowed amount for each of our contracted plans. If the patient is well known we do sometimes offer short term payment plans, especially if they are having a more expensive procedure.

In the new era of 6k deductibles its really the only way we could survive!