Check the Language in the Contract

One of the best kept secrets in billing is what might be contained in the language of your contracts with health plan carriers. The cost of collecting a $10 co-pay after the visit is usually about $8 per statement, and that doesn’t include the tracking and additional phone calls necessary to collect what is a minimal amount.

Of course, it’s always best (and often required) to collect the co-pay or any other fee up front. Sometimes, though, that isn’t possible and you are left with pursuing two options: Attempt to collect the co-pay or write the balance off. Both cost your practice money. Before determining your solution, take a look at your existing contract. Many contracts have language that states patients must pay their portions within a specified time frame. If that contract is broken by patients not paying in a timely fashion, you may not have to write off contractual obligations but instead charge patients the co-pay and the amount of the service you wrote off due to the payer contract.

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Follow these steps to reduce your collections and prevent small balance frustrations in the future.

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  1. Check the language in your contracts; and, if there is no language on when a beneficiary has to pay, ask to have it clarified or added to your contracts.
  2. Once you have the language confirmed, contact patients. Let patients know they have a short period of time to pay (such as 10-15 days). Tell them if payment is not received, they will be in breach of the contract and the new amount due will be $xxx (Add what you had to write off for contractual payment.). Normally, this is a significant increase and most patients will pay quickly. Those who can’t will contact you regarding payment arrangements.
  3. Follow up if you don’t hear from the patient after the notification. Be sure to add the extra from the contractual obligations back on to their bill. Make a special code that spells it out to the patient where the additional cost was incurred. If you end up turning the amount over to a special collection agency, be sure to give the agency a copy of all correspondence.

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