Effectively Collecting Payment from Patients

By: Kathy Mills Chang

If You Don’t Ask, You Don’t Get! 

Recently I was asked, “What’s the most effective tip you can give regarding increasing collections in an office?” I hesitated giving the answer that made the most sense to me, because I feared it would sound flippant. Then I gave my answer anyway: “The most effective method I have found for increasing office collections is… ask for payment.” At first, there was a confused hush in the room, then giggles, then a round of applause. I went on to explain the reason I believe most offices fail to collect, both from insurance carriers and from patients.

I’m sensitive to the fact that not everyone has the ability or knack to ask for payment. There truly is an “art” to asking. But as Gandhi said, “If you don’t ask, you don’t get.” When dealing with ancillary services and products such as functional orthotics, too many doctors choose not to ask; they assume the patient would not want to pay out of pocket for such an item, if third-party coverage didn’t exist. I’d like to share the reasons and the methods I revealed to that group, in the hope that you may be able to get the edge needed in today’s heath care environment.

Getting Your Patients on Board

The most important concept when asking for payment from a patient is that of perceived value. The patient must assess a value either at or greater than what they are being charged in order to be on board with the cost of the service or the product. It’s equally if not more important for the team member dealing with finances to understand the perceived value of the service for themselves. As the saying goes, it’s difficult to sell what you don’t own.

This has never been truer than with functional orthotics. We always recommend that team members have orthotics in their shoes and understand all the benefits of wearing them, in order to be an advocate for patients who have had them prescribed. I have consulted with many offices where the primary staff member whose job it is to collect payment has confided to me that she just can’t ask these poor people to pay for what she couldn’t afford. Let me share a story about a doctor who understood the value of his service and a patient who “got it.”

“John Smith” presented to “Dr. X” with significant lower back pain and was unable to do the full extent of his job duties. Mr. Smith was definitely a blue collar-type worker, with the wear and tear of outdoor work on his body and face. The doctor performed a complete orthopedic and neurological examination and X-rays of the affected region, as well as a foot scan using the 3D BodyView® imaging system. He detected a noticeable asymmetry in the patient’s feet on the foot scan, noteworthy imbalance from the left foot to the right and much more weightbearing carried on the front of his feet than the heels. Further examination also revealed bilateral navicular drop, foot flare, and internal knee rotation.

Dr. X explained the findings to the patient and what it would take to provide relief and correction. The doctor further explained the importance of functional orthotics as a part of the treatment plan. While the patient had decent third-party coverage, there was no coverage for the functional orthotics. Nevertheless, they were necessary, and would need to be paid for out of pocket.

Mr. Smith went to the front desk and immediately laid $300 on the counter for the functional orthotics. He realized that functional orthotics could be the answer to his chronic back problems. Mr. Smith also realized that if he let his condition go much longer, he may not be able to work; and if he couldn’t work, he couldn’t feed his family. Therefore, he “made do” until he could pay for the care and the orthotics. He had attached a greater perceived value to the care than anyone expected him to.

This is a testimony to the adage, “Stay out of patients’ pocketbooks, because you don’t know what they can or can’t afford.” Do not prejudge what a patient can or can’t do financially. It is your responsibility as a doctor to tell your patients what they need to hear about needed care, including all the recommendations. If a patient would benefit from orthotics, as we know 80% of the population would, they should be included in the recommendations. Let patients make their own financial decisions.

Exercise Your Asking Muscle

Now that we know the “whys” behind telling it like it is, let’s explore the “hows.” Here are some ways to maximize your results when asking for payment from a patient for things above and beyond the third-party coverage:

● Ask as if you expect the patient to say “Yes!” The person who asks for payment from a patient should not be averse to doing so. It’s the conviction in your mind that will see it through to the end. When you assume that you can, you approach the situation with action in mind. If you assume you can’t, you’ve already lost.

● Be clear and specific about what you are asking. When dealing with finances, you must be prepared. Have the doctor’s treatment plan, the insurance verification information, and everything else you will need to formulate an appropriate financial plan with the patient. If you are asking for payment for a single date of service, be clear what the service rendered is, what it entails, and the exact fee for that service. Be prepared to give whatever explanation is necessary.

● Be aware of resistance. Not everyone will be able to pay cash for services and products, unless you can make it affordable with budget-sized payments. Know what alternatives you have available for the patient, and if there is resistance have them available.

● Don’t be afraid of hearing “No!” Getting patients to agree to out-of-pocket expenses will not be effective every time. We want to increase our odds by using some of these techniques. However — remembering that the most important technique of all is to know you can get what you want by asking — if it doesn’t happen, be prepared to say, “Next!” Don’t give up if you experience resistance right away.

In closing, remember that he who asks the question controls the conversation. Not only is it our duty to ask for and collect payments from patients, it is a part of the healing process. The patient who pays will stay and get better quicker. Asking for anything increases the odds of getting it by 200%. Once you master this skill, exercise the asking muscle often, and you’ll be surprised at how effective it is.

About the Author

Kathy Mills Chang is the founder of her own consulting firm, assisting doctors with finding financial and reimbursement ease in practice and helping them to make and keep more money. She also serves as Foot Levelers’ insurance advisor and can be reached for service and questions through her website at www.kathymillschang.com or by email at Kathy@kathymillschang.com