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5 Tips for Orthopedic Practices to Collect in Full More Often

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Here are five tips for orthopedic surgeons and groups to collect in full from patients and insurance companies more often.
1. Write a financial policy upfront for patient collections and let patients know your expectations before the appointment. It's important for practices to have a written financial policy for collecting from their patients. Part of this policy should include securing authorization and payment information before their appointment. Contact eligible patients before the visit to make sure they remember their appointment and understand the payment policy. You should clearly communicate how long the payment process will likely take and set some expectations about what will happen. Based on the payor, give a final estimated amount on what the patient's level of responsibility.

2. Collect payment at the time of the appointment. According to revenue figures from a recent Medical Group Management Association survey, 20 percent of office revenues come from patient co-pays — yet most practices only collect 60 percent of those fees. That means the average practice is leaving 8 percent of its total annual revenue on the table.

To ensure co-payments at the time of service, ask for payment as the patient arrives — not after service. Also, estimate the patient's responsibility beforehand, and get up-front authorization to charge his or her credit card within a range of that estimate. Other steps you can take include sending out statements more frequently than once per month, offering online payment, and making multiple payment options the norm. Many practices write off outstanding patient balances of $25 or less. All this does is encourage non-payment, especially among patients who have $10 co-pays. Thanks to automated collection software, the cost of pursuing past-due collections has dropped to under $5, making it possible to clear up these low balances and increase your monthly income.

3. Check for patient coverage before the visit.
One of the ways practices most frequently lose money is by seeing patients who are not eligible to receive coverage on their treatment, Dave Wold, CEO of Healthcare Information Services. Eligibility software allows physicians to check the availability of the patient's coverage before he or she comes into the office. The software will show the patient's coverage status and whether the patient has unmet deductibles. If the patient does not meet coverage requirements, the practice has time to speak with the patient before the appointment and make prior payment arrangements.

4. Have a method for accounts receivable. Not keeping track of the accounts receivable and billing process is one of the biggest mistakes orthopedic practices can make, says Nancy Moore, president of NBP, a practice management support company. "Often, the physician trusts employees to do the best job possible to manage the A/R and billing process, and sometimes it's not being handled well," she says. "Employees should be educated every year about reimbursement changes and carrier level changes. You also have to have good oversight from the management."

The trained employees who handle the revenue cycle responsibilities should be compensated appropriately because these employees are controlling the practice's cash flow. "In oversight, employees really need to be held accountable, incentivized and rewarded for good work," says Ms. Moore. "This doesn't always happen, especially now when it's tough to get reimbursement, but at the same time you can't cut corners." Orthopedic practices should set solid goals for the revenue cycle managers, such as maintaining the A/R greater than 120 days at 15 percent or lower of total A/R, a net collection ratio greater than 95 percent, and incentivize employees with compensation when goals are met.

5. Include a personal note with the bill. When patients receive a bill at home for their medical services, they don't always connect the physician with the bill. People often feel freer to ignore healthcare debt than credit card debt. Including a short cover note from the physician discussing the importance of timely bill pay can help collect quicker. Have a cover note from the physician that follows up with the patient's condition and asking them to pay the enclosed bill on time. Tell the patient that you are able to provide good care because of their payments. Tell them the payments go toward things like the nurses' salaries or continuing education. This can make a difference in payment patterns.

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