Practice Management Alert

No one likes to inform patients when payers back out of reimbursement but you can make collection less painful by offering support and understanding.

For starters, keep in mind that not only dollars are at stake. Anxiety about finances jeopardizes patient treatment and healing. At infertility clinics, for example, where expensive patient bills are frequent, if patients are stressed, the likelihood of success is threatened, and you have a problem, says Victoria Jackson, administrator and chief executive officer of Southern Orange County Pediatric Associates in southern California.

For many patients, including those with cardiac conditions, stress can hinder healing, adds Adrienne Rabinowitz, CPC, billing manager for Western Monmouth Orthopedic Associates, a three-physician practice in Freehold, N.J. Recognize the importance of your job in terms of patient health, and you're more likely to reach a peaceful resolution and collect payment from patients. "[Patients] need to know that we really do care about them. You would be amazed at how far that goes," Rabinowitz says. You can further minimize the stress that expensive bills cause your patients and your office by adhering to the following advice. Prepare Patients for Worst-Case Scenarios Give patients time to digest potential financial burdens: Tell them in advance if insurance companies hesitate on commitment, and help them set up a financial plan in case reimbursement doesn't follow through. Here's your guide for gently breaking news to patients. Contact the patient's insurance company first. Before you meet with the patient, call the insurance company, take down all the information, note the representative with whom you spoke, which department she's in, and the date of the call, Rabinowitz says. Then add the information to the patient's account. This preliminary work allows you to trace the insurance company's statements if it denies payment. Plus, you're letting the patient know you're invested in having insurance cover what could be the patient's bills. Brace your patient for the worst, if the insurance company sends you a predetermination letter stating, "Yes, these codes are covered, but they're subject to review." Let the patient know that "review" could mean a decrease in reimbursement amounts. Your prediction will keep your patients calm.

Open and clear communication with the patient helps keep stress levels to a minimum, Rabinowitz says. "A well-informed patient tends to be a happier one." Talk it out with the patient. Sit down with the patient, explain the financials, and work out a payment plan if the forecast shows patient responsibility. Make sure it's the patient who decides which payment plan works best, she insists. Let the patients know that if anything develops, they can contact you and that you can always adjust the plan if necessary, she adds. Protect Yourself with Vigilance and [...]