MedEvolve Blog

Since doctors began taking the Hippocratic Oath, they have struggled with requiring payment for treatment of patients. For a doctor, it is their duty to treat a patient and sometimes they may be too willing to dismiss a copay or balance due because they empathize with a patient’s situation or maybe have a long-standing relationship. Collecting money that is owed is awkward for most business owners if a client does not immediately offer payment when it comes due. An unfortunate consequence of the increase in patient financial responsibility is that the practice of collecting on patient balances can turn you, your practice, and your staff into the enemy—the dreaded debt collector.

According to the U.S. Code of Federal Regulations, a practice must “make a reasonable effort to collect” on a patient bill before it can be considered a write-off.

What Defines a “Reasonable Effort to Collect?” 

With respect to Medicare and Medicaid, “reasonable effort to collect” has been interpreted to mean that the provider sends three statements to the patient and if the patient does not respond, the account may be written off.  Since third party billing rules can be difficult to decipher and differentiate, it’s typically a best practice to use Medicare and Medicaid as the standard for all payers.

Specialty practices are facing enormous challenges collecting on patient balances and managing healthcare payer relations.  They must make patient collections an even greater priority than other providers or hospitals, as their margins for services are often much more narrow. Optimal revenue cycle management is a crucial component to cutting costs and helping to ensure consistent cash flow.

Specialty practices need to have processes in place to ensure claims are submitted correctly the first time, to prevent costly denials, and they should make every effort to collect patient balances up front, or while the patient is in the office.Once the patient leaves, practices also should have a consistent process for delivering statements to patients and collection letters when necessary.If you don’t, you could be losing out on revenue that you need to stay in business.

With the rise in popularity of high-deductible health plans (HDHPs) comes an increased burden on your billing department and an increased burden on your patients. Most likely, your billing department is not accustomed to collecting money from patients, yet the need to has ramped up in the last few years. Today, your patients are most likely your largest payor, and if you don’t have the right process in place for collecting payment in a timely manner, your practice’s financial future could be in jeopardy.

MedEvolve is excited to add Jim Crook and Jon Phillips to our Board of Directors to help guide our strategy for future growth and expansion. Both gentlemen will offer new insights along with a wealth of knowledge and experience growing healthcare IT companies.

Here is an excerpt from our press release:

“Jim Crook has over 35 years of leadership experience with a strong track record of growing companies in healthcare IT.