From copayments and deductibles to having to deal with outstanding balances, an effective patient collection process is vital for any healthcare provider trying to remain financially stable.

Throughout this article, we’ll be looking at all things to do with your patient portal, hopefully shedding some light on how prompt patient payments can affect your practice’s overall cash flow.

In addition, we will also be taking a look at some of the best ways of improving patient collections for medical practices, equipping you with all the knowledge you’ll need to ultimately ensure financial stability and success for your practice in the long run. Let’s begin!

The Basics of Patient Collections

Firstly, let’s begin with some fundamentals that are worth memorizing for health care organizations. In essence, patient collections refer to the process of collecting any of the outstanding balances from your patients for the medical services your practice has rendered.

This isn’t as seamless a process as it might imply, unfortunately, and there are often many hiccups when it actually comes to collecting payments from patients. Instead, the patient collection process usually involves fairly systematic management of all the various medical bills, payments, and outstanding balances of all your patients.

Still, this is an absolutely vital part of your overall revenue cycle management, so establishing a streamlined payment process is critical if you’re aiming to reduce your accounts receivable days.

So, let’s take a closer look at how patient collections actually work in practice.

1. Verification of Insurance

The first step in almost all patient collection processes is to verify your patient’s insurance coverage. This includes a range of factors, but mainly you’re looking to determine the scope of coverage, co-pays, deductibles, or any other financial obligations that your patients could have.

At this point, you’d normally explain the patient financial responsibility, so it’s clear what your payment terms are for all parties involved.

2. Pre-authorization

Not all, but some of the medical procedures or treatments you’ll provide might require pre-authorization from the insurance company first. Essentially, this just ensures that all the services you provide will actually be covered by the patient’s insurance plan.

3. Billing

After your practice has provided the medical services, you then need to generate some form of invoice or statement that can clearly display all of the services rendered.

This document usually just outlines all the relevant services and costs – nothing different than your medical practice would’ve sent in the past to receive healthcare payments.

4. Submission of Claims

Next, your medical practice needs to submit these claims to the patient’s insurance company so you can seek reimbursement for the services provided.

This step is crucial and typically is best overseen by professional medical coders as you need to adhere to specific coding requirements so you can ensure accurate claim submission.

5. Insurance Reimbursement

Once the insurance company receives the claims, they review and process them. Afterwards, they’ll then reimburse your practice for all of the approved services based on the coverage and contract agreements.

6. Patient Statements

If there are still any outstanding balances after you’ve received the insurance reimbursement, your medical practice then generates patient statements that basically detail the remaining balance and inform the patient of their financial responsibility.

7. Payment Collection

Almost finished! Now you just need to communicate with the patient so you can collect payments.This can be done through various different means, like phone calls or even mailed statements.

This part can be slightly tricky for certain customers, so offer flexible payment options to make it easier for patients to settle their bills if financially viable.

8. Follow-up and Resolution

In some cases where your patients might fail to make payments or just have difficulties meeting their obligations, you might need to engage in further follow-up.

Usually, this includes negotiating payment plans, discussing financial assistance programs, or even involving collection agencies as a last resort.

Outsourcing to PMN

Understandably, walking the fine line between helpful patient reminders and ensuring you’re never running into any cash flow issues isn’t particularly simple for medical practices – especially smaller-sized organizations.

As a result, many healthcare providers in California choose to outsource these responsibilities to a medical billing company instead, such as PMN.

When it comes to patient collections in particular, PMN brings over 20 years of expertise to your practice. Not only can you improve your collection rates with PMN, but you’ll also be able to optimize other major areas of your practice through monthly reports and audits.

If your medical practice currently operates within California and you’re interested in hearing more about how PMN can assist, don’t hesitate to get in touch today by calling (949) 215-5055. In addition, you can book an appointment for an in-person chat at their lovely office in Laguna Hills, Orange County, California!

FAQs

How Can I Measure The Effectiveness of My Patient Collection Strategies?

Usually, it can help if you track and analyze some of your key performance indicators, like collection rates, accounts receivable ageing, and even surveys of how satisfied your patients are. In addition, make sure to regularly review your strategies based on some of these metrics in order to fully optimize your collection processes and stay financially stable.

How Can I Handle Sensitive Patient Information During The Collections Process?

Though easier said than done, aim to adhere as strictly as possible to any patient privacy laws, like HIPAA, whenever you’re dealing with patient debt. This goes for all your staff, too, so ensure they’re all trained properly on privacy practices and how to handle patient information with the utmost care.