When it comes to practice revenue, your schedule is your bread and butter — but your collections are your paycheck. You may have an appointment book just bursting with patients, but if they don’t pay you, you won’t receive a paycheck. Obviously, collections are a very important part of your practice. If your office has poor collection practices, you won’t have a healthy practice.
The first thing you need to check is your staff’s mind set regarding collections. If your staff members are un- comfortable asking your patients for payment, you’re in trouble. They must believe in the value of your treatment. If your staff does not thoroughly understand the value of what you do, they will be uncomfortable asking for payment, and your patients will sense that.
Certainly, if your staff is not confident when asking for payment, your collections will be affected. You should have a staff meeting and talk about the benefits of chiropractic care. No chiropractic assistant should be in a position to collect payments unless he or she believes the fees are worth the required payment. You must educate your staff about what you charge and why.
It is important to know the effects of poor collections and how that can affect your patients. Here are two universal laws when it comes to collections:
- The Law of Equal Exchange. There has to be a feeling of equality. When you give patients a service, they must pay you for it in order to feel equality. When patients owe money, they have to justify the imbalance, even if it’s subconsciously. Some of them will “justify” it by not getting better.
- Patients who owe money will drop out. Patients cannot continue to build up a balance and feel okay about it unless they justify why they owe money. The only way patients can justify owing money is by trying to convince themselves they are not getting good chiropractic care. The higher a patient’s balance gets, the more frustrated the patient becomes, and suddenly, he or she may drop out. The patient may even verbalize his or her frustration by bad-mouthing your care to others.
The bottom line is you are doing your patients an injustice by not collecting for the service you are performing. If you want your patients to get better and refer others to your office, make sure you collect what they owe.
If your office has a collections problem, you must take steps to solve it. The way to begin is to let new patients know from the beginning that you take your collections seriously. Collect what is due from the patient from the very first visit.
Other collections tips include:
- Good collections begin from the very first phone contact. Make sure your CAs tell new patients that you expect payment on the day of their first visit. Whether the patients will be paying a co-pay or the entire amount, you must let them know that you expect payment at the time of service. Have your staff tell patients there will be a charge and what types of payment you accept. They will be more likely to come in prepared to pay. It helps to accept credit cards. The small cost involved is worth it.
- Have a written financial policy for new patients. This form should explain your office policy with regard to payment and should be signed and dated by every patient.
- From the very first visit, know each patient’s responsibility with regard to payment. Your staff may need to get the insurance information before a patient’s first visit. Before the patient is treated, a CA must explain financial responsibility and get an agreement from the patient.
- Make sure your front desk knows exactly what to collect from each patient. If the patient leaves the office without paying on the first visit, you are setting a precedent from which it will be difficult to recover.
- It’s advisable to let patients know you will accept advance payment. Patients often will ask to pay at the end of the week instead of every visit. Tell your staff to let patients know that advance payments are acceptable, especially if they have a co-pay.
- If patients suggest paying only once a month from a statement, your staff should tell them that is against your office policy; but suggest your office keep their credit card number on file for their convenience. That way, they can pay their credit card company once a month. As with any communication, the patient should understand that your office is trying to make things as convenient as possible for them. Of course, you are also getting what you want, too.
- If you decide to give a patient a hardship discount, be sure your staff collects payment of the agreed-upon fee every visit. It is better to discount the fee and get paid every visit, then it is to charge a full fee and have a balance due. The patient will feel better, and you will not have the negativity of a balance due. Make sure there is really a hardship. Often when patients tell you they cannot afford care, it is due to misplaced priorities.
- Keep self- addressed envelopes at the front desk for patients who forget their checkbooks. The front desk CA can give these patients an envelope and ask them to mail the check when they return home. A nice touch is to include a postage stamp; they will be more likely to send the check.
- If patients ask if they can pay their bill on pay day, have your staff suggest they write a post-dated check that can be held until that date. An alternative is to suggest the use of a credit card.
- Make sure you have an office policy that covers all scenarios. When a patient requests special privileges, be sure your staff members blame the “office policy” as the reason they cannot agree to the request. They should never blame you. The doctor is the healer, not the collections agency. If a patient mentions money, you should say, “Please see _________; she is in charge of the office business.”
- Keep a professional distance with patients. I call it a professional boundary. If you stay on the side of professionalism, the patient is less likely to ask for special favors.
- Finally, take collections as seriously as you do every other system in your office. It is not okay to put off payment any more than it is not okay to cancel visits.
If you follow this advice, collections in your office will be as painless as possible. Start right from the beginning and get your patients to pay at the time of service. Not only will you be helping your clinic thrive; you will also be giving yourself security. Of course, the best part is that you will be helping your patients get the help they need. It is a winning solution for everyone involved.
