Busy administrators often get swept up in managing the day-to-day operations of their practices. Stepping back and looking at things from a different perspective can sometimes result in making changes that can increase the efficiency in the practice – often with accompanying improvements in staff and patient morale. Everybody wins!
Various trends, such as rising co-pays and higher deductibles, are shifting more of the burden onto patients – who are themselves dealing with a reduced capacity to pay. Sometimes it seems that busy or cash-strapped patients are also more likely than ever to cancel their appointments, or, even worse, fail to show up without a cancellation call. Your staff may be put into increasingly awkward positions as a result, e.g. dealing with a patient asking to mail in a check later instead of paying at time of service, or confronting repeat offenders who routinely skip their appointments. Staff may feel their job satisfaction waning as more of their time is spent being “bad cop.” Worst of all, these unhappy interactions often don’t even have the intended effect of improving patient compliance!
The powerful economic trends behind some of this behavior are inescapable, and, to a certain degree, medical practices are going to face the same challenges all businesses face in this environment. But, too many practices just accept that all their collection and scheduling problems are unsolvable – when the fact is, it is possible to do much better by being willing to look at your procedures with an eye toward improving and taking control. Leaving it all to chance will cost your practice plenty!
Manage your patients’ behavior
The key is to adopt a mindset of managing your patients – your physicians manage their health, you need to manage their business behavior with your practice. There are many ways you can do it without being offensive or bossy or straining the relationship. In fact, managing your patients better is in many ways a form of clearer and more effective customer service.
Consider two big areas where patients let you down: keeping appointments and prompt payment. How you communicate with patients makes a big difference in whether they do what you want.
Whether or not your patient keeps his appointment (and arrives on time) is influenced at several touch-points:
- When they register as a new patient, are you asking for several forms of contact information – home phone, work phone, cell phone, email – and, most importantly, learning what the best ways to contact are, and the best times? Are you getting permission to contact via multiple means?
- Are you reconfirming that information each time the patient schedules or comes in for a new appointment?
- Are you contacting the patient 2-3 days prior to the appointment for a reminder?
- Are you contacting patients who no-show after the scheduled appointment to find out what happened, get better contact information, and reschedule? Do you remind them how important it is to keep scheduled appointments?
- Do you have a clear policy for late and no-show appointments – i.e., a “three strikes and you’re out” policy for dismissing chronic offenders?
- When patients come to the practice for their appointments, are they seen promptly – within 15 minutes of their scheduled appointment –and, if not, are delays adequately explained?
Contacting patients in the way they prefer, reminding them far enough out that they have time to reschedule if necessary (but not so far out that they forget!), and being on time for patients who arrive on time are all important ways to show patients that you value their time – and that you run a tight ship. And having a clear policy for terminating patient relationships when the patient simply won’t respect the need to keep appointments sets the foundation for patient compliance.
Payment compliance requires clear and direct communication
With payment compliance, the need to be clear and direct is similar. Is your practice:
- Confirming insurance coverage and determining co-pay and co-insurance amounts payable at the appointment, and letting the patient know what their financial obligation will be as part of the appointment reminder call?
- Asking patients for payment in a presumptive way, e.g., “How will you be paying your co-payment today, Ms. Evans?”
- Establishing clear payment terms for larger expenses like surgery before the costs are incurred?
- Billing promptly and handling all inquiries about bills promptly as well – so there’s less chance of the patient not recognizing the amount due?
- Sending past due accounts to collections if no payment is received after two statements – and making clear to patients that this is the standard process?
Staff members need to be trained to ask for payment in a way that’s not timid or open to discussion (i.e., not “will you pay your co-pay today?” but “how will you be paying your $120 balance today?”). Most patients will simply present a credit card when payment is not posed as optional.
Of course, even the most organized practices will have some patients who accumulate bills they don’t intend to pay. For those patients who will be slow-payers or non-payers, it’s always best to learn that faster – to avoid wasting more money and staff time on fruitless, discouraging collection attempts. These patients can be ethically dismissed – much like the unrepentant no-show problem cases – and physicians and staff can use the time freed up for more profitable and positive activities.
Judy Capko is a healthcare management and marketing consultant, speaker and author or the best-selling book: Secrets of the Best-Run Practices. She is based in Thousand Oaks, CA, and can be contacted at www.capko.com. In September, Judy wrote on How Do Your Payers Stack Up?
