Finding the Right Balance Between Empathy & Financial Success –Collections At Time Of Service

When it comes to collections at the time of service, we are often torn between our empathetic human natures and the necessity to keep our businesses afloat. We are all aware that there has been a shift in insurance premiums and patient financial responsibility over the last few years, making insurance no longer an entitlement, but a necessity that has become consumer driven. Accountability has shifted from insurance carriers to patients, who are now responsible to obtain their coverage, as well pay thousands of dollars toward high deductibles, co-pays and out-of-pocket amounts. Occasionally, we allow our emotions to control us and feel sympathetic towards patients stressing over money.

Looking on the business side of things, we cannot afford to NOT collect money upfront. Collections at time of service are vital to the success of our cash flow. When we waive payments or accept promises of “I’ll pay it when you send me a bill,” we are less likely to obtain this money. Think about it – it is much more difficult and costly to bill patients after their visits. Not only are they out of your doors (“out of sight, out of mind” philosophy), you now must also spend extra dollars on labor, statements, and postage.

We need to make a paradigm shift from our timid natures to educating our patients. Educated patients are empowered patients. We should not be afraid to let them know payment is required at the time of visit – it is their responsibility to the benefit level of their insurance carriers (and as contracted providers, it is also our responsibility to hold patients accountable). We can handle a request for money compassionately by setting the stage early with our patients and educating them that:

  • They agreed to a certain upfront payment amount when they signed their insurance coverage contract.
  • The more money that is collected upfront now will help eliminate a much larger bill down the road (and in some cases, help eliminate interest).
  • Medical services are no different from any other services. Groceries require money at time of service. Gas stations require money at time of service. Your office is no different.

Of course, it is vital that during treatment, we “wow” our patients. They are more likely to cooperatively pay money upfront, as well as their entire bill, for services that they find valuable.

No matter how well we educate our patients, we also need to have the proper protocols and procedures in place to successfully collect upfront. Below are a few tips and tricks that I have found to be helpful when collecting upfront amounts:

  • Verify patient benefits prior to the visit/treatment if possible.
  • Create a written financial policy for the patient to sign and discuss upon arrival.
  • When making reminder calls, remind patients to bring their wallet or checkbook.
  • Be sure all administrative staff members are comfortable collecting money.
  • Remind patients of renewing deductibles at the end of the year (if they have ongoing treatment).

The shift to greater patient responsibility is here to stay. With the right systems and proper patient education, we can help eliminate the feelings of guilt for requesting money at the time of service, and focus on the financial success of our practices. Any additional things you have found to help in your practice, please add in the comments section. Together, we call all grow from our collective knowledge.

Stay tuned – I look forward to provide additional education on this topic in November through my web event: “Upfront Collections: Predict the Success of Your Cash Flow.” Details to come soon at