The best way to improve the patient payment component of the revenue cycle is to collect cash payment in advance for healthcare services. However, without solid processes and disciplined implementation, upfront cash collection can challenge and frustrate front office staff, often contributing to accumulation of outstanding patient debt. Insurance companies sending payments directly to patients instead of the office further exacerbate the difficulties of debt collection.

A typical debt-processing scenario proceeds in three phases, starting with billing, to debt accumulation, to selection of the most appropriate collections method. Clear definition of responsibilities along with payment arrangements help effective collections, minimize practice risks, and reduce administration costs.

Billing Phase: Your billing office sends patient invoices and a number of reminder invoices regarding outstanding balance directly to the patient.

Debt Accumulation Phase: The patient does not pay the invoice for a time period exceeding desired limit (typically, 90-120 days). Accounts receivable distribution over the span of 30, 60, 90, and 120 days takes the shape of inverted horizontal S.

Debt Collections Phase: The practice must consider at least four alternatives for outstanding debt collection:

1. Dismiss the patient until all debt is paid.
2. Offer the patient the opportunity for a financial hardship write-off.
3. Take the patient to small claims court.
4. Hire debt collections agency.

First, dismissing a patient is not always an appropriate option because of associated reputation implications and potential medical malpractice risk. More importantly, dismissing the patient only stops subsequent debt accumulation but does not eliminate the already accumulated debt.

Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

1. Specialized Industry Expertise
   • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
   • "Skip-tracing." Ability to find patients that changed addresses or names
   • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
   • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
   • Retail Management Interview – READY?
     Are you ready to make that internal move? Retail provides many opportunities to move up, move quickly and move often. You may be interviewing for positions such as Key Holder, Assistant Manager and Store Manager or even as a Regional Manager. The concept is the same. How are you and your experiences able to provide the numbers, able to keep operations in line and all while keeping client experience high? You have one shot to prove it and that is in the interview.PREPARATIONThe single most important part of being ready for an interview is preparation. Like anything else in life, the more prepared you are, the easier and more successful you will be at the task at hand. You owe it to yourself, putting your career on the line, to take as much time as possible to prepare for any interview.Anticipate the QuestionsAdvantage is in knowing what is going to be asked. First, look for internal sources. Discuss your intentions with your suppor
     of outstanding patient debt. Insurance companies sending payments directly to patients instead of the office further exacerbate the difficulties of debt collection.

     A typical debt-processing scenario proceeds in three phases, starting with billing, to debt accumulation, to selection of the most appropriate collections method. Clear definition of responsibilities along with payment arrangements help effective collections, minimize practice risks, and reduce administration costs.

     Billing Phase: Your billing office sends patient invoices and a number of reminder invoices regarding outstanding balance directly to the patient.

     Debt Accumulation Phase: The patient does not pay the invoice for a time period exceeding desired limit (typically, 90-120 days). Accounts receivable distribution over the span of 30, 60, 90, and 120 days takes the shape of inverted horizontal S.

     Debt Collections Phase: The practice must consider at least four alternatives for outstanding debt collection:

     1. Dismiss the patient until all debt is paid.
     2. Offer the patient the opportunity for a financial hardship write-off.
     3. Take the patient to small claims court.
     4. Hire debt collections agency.

     First, dismissing a patient is not always an appropriate option because of associated reputation implications and potential medical malpractice risk. More importantly, dismissing the patient only stops subsequent debt accumulation but does not eliminate the already accumulated debt.

     Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

     Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

     Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

     Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

     1. Specialized Industry Expertise
        • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
        • "Skip-tracing." Ability to find patients that changed addresses or names
        • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
        • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
        • Multi-Level Marketing - Is It An Extension of Franchising?
          Ray Kroc, founder of McDonald’s Corp., did not set out to sell Big Macs. His introduction to hamburgers came in the early 1950’s while he was peddling milk shake machines.A San Bernadino restaurant run by two brothers, Dick and Maurice “Mac” McDonald were using a number of the machines to keep up with the huge demand for milkshakes. It was here that Kroc saw a golden opportunity for lot’s of milkshake machine orders if only they had more restaurants! Kroc offered to open and run the restaurants, and in 1955 opened the first McDonald’s in Des Plaines, IL. He bought out the McDonalds brothers for $2.7 million in 1961.Ray Kroc understood one important fact about business that most of us simply miss. The fact is, that you will make far more money by “duplicating” your efforts over and over again in a mutually beneficial way, than by trying to due it all by yourself. Ray went out of his way to find qualified individuals to run and manage his restaurants, and after training them a
          od exceeding desired limit (typically, 90-120 days). Accounts receivable distribution over the span of 30, 60, 90, and 120 days takes the shape of inverted horizontal S.

          Debt Collections Phase: The practice must consider at least four alternatives for outstanding debt collection:

          1. Dismiss the patient until all debt is paid.
          2. Offer the patient the opportunity for a financial hardship write-off.
          3. Take the patient to small claims court.
          4. Hire debt collections agency.

          First, dismissing a patient is not always an appropriate option because of associated reputation implications and potential medical malpractice risk. More importantly, dismissing the patient only stops subsequent debt accumulation but does not eliminate the already accumulated debt.

          Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

          Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

          Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

          Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

          1. Specialized Industry Expertise
             • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
             • "Skip-tracing." Ability to find patients that changed addresses or names
             • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
             • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
             • Are You Godiva Chocolate
               Has this every happened to you? You have an account that owes your company a considerable amount of money. Everything goes well for awhile. The payments are made on time, the debtor calls you just because he wants to know how he can make your day better (hey, this is my dream!).Then one day no more calls and worse yet, no more payments. You, being the good employee that you are, attempt to call them and you discover that they have disappeared off of the face of the planet. So, you go back through your previous issues of Collection Advisory to look in the Skip Trace column to ensure your best possibility of finding your debtor. You begin your search process and you can not find any thing, WHAT NOW?The question is, are you looking for the right information? Confirming the information that you begin with is essential. Are you certain that the name, address social security number and phone number were TOTALLY correct from the start? I know the debtor gave you every bit of information that you a
               tops subsequent debt accumulation but does not eliminate the already accumulated debt.

               Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

               Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

               Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

               Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

               1. Specialized Industry Expertise
                  • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
                  • "Skip-tracing." Ability to find patients that changed addresses or names
                  • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
                  • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
                  • Utopia? Imagine a Community with Free Fundraising
                    I close my eyes and imagine how free my community would feel if all of its fundraising needs were consistently met. Every child could be adequately clothed, nutritiously fed, and attending a well-equipped school. Local sports teams, the Boy Scouts, etc. could be more affordable – maybe even free -- for struggling families. My hospital could have more beds, staff and equipment which would mean reduced waiting time for scheduled surgeries, or in their emergency waiting rooms. Local cancer clinics, respite care, and health research projects could all improve the quality of life for my whole community, thanks to adequate funding for salaries, research, and maintenance. They could even save more lives.I could go on and on; the list is endless. But you get the picture. An adequate supply of funds, on a continuing basis, would make everyone’s life more comfortable, and my local community would be a happier place to live.The problem with conventional fundraising
                    round industry knowledge, performance, control, costs, and interaction between billing and collections services:
                    1. Specialized Industry Expertise
                       • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
                       • "Skip-tracing." Ability to find patients that changed addresses or names
                       • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
                       • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
                       • Understanding of Billing Processes Knowledge of healthcare claims processes and ability to successfully negotiate with insurance companies

                    2. Proven Performance
                       • References. Provide a list of specialty-relevant references.
                       • Quantitative Performance Measurement. Compare collections performance including percent collected and time to account liquidation.
                       • Client satisfaction. Demonstrate long client retention history.

                    3. Centralized Control
                       • Transparency. Provide real time status on all collection activities, including amount collected, actions taken, and patient responses. Include a wide selection of reports available over a secure Internet connection 24 x7.
                       • Tight Cash Flow Control. All collected money goes directly to your practice or bank account, increasing positive cash flow and immediately collecting interest. No waiting for a collection agency to take its percentage first and pay you at its convenience.
                       • Lower Risk with Indemnification. Collections agency must indemnify your practice from lawsuits resulting from collection efforts through a written hold-harmless agreement.
                       • Flexible Contact Style. Avoid offending your patients. Collections agency must be able to vary its patient contact style (e.g., diplomatic or intensive) on a patient-by-patient basis according to your specific direction.
                       • Patient Relationship Maintenance. Collections agency must not intrude on your relationship with your patient. If you choose so, you should be able to maintain continuous control of patient's account, including negotiation of payment plans or dispute resolution directly with your patient as a key element of the collection process.

                    4. Economies of Scale and Fees
                       • Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
                       • Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency mu