It is becoming increasingly challenging for healthcare facilities to ensure good cash flows despite the need to offer patients quality services. The impact of unpaid balances can be considerable, particularly as high deductible insurance policies shift financial liability to patients. Although medical debt collection companies are very useful in the recovery of outstanding amounts from patients, there are some aspects that doctors need to consider when sending patient accounts to debt collectors.
Poor decision making during selection of the right debt collection strategy can cause problems not only financially but also legally. Before sending patient accounts to a debt collection agency, there are some crucial questions that doctors need to ask.
Have All Internal Collection Efforts Been Exhausted?
Prior to involving any external agency for collections, doctors need to ascertain whether or not all the internal collection measures within the practice have been exhausted. A majority of the outstanding bills are due to misunderstandings in the billing system, delays by insurance providers, or forgetfulness on the part of the patient.
It is important for the practice to ensure that more than one bill has been issued, calls/ texts have been placed for follow up, and alternative means of payment have been presented to the patient.
An effective internal collection procedure can help settle many of the outstanding balances without the involvement of any external assistance.
Is the Debt Accurate and Properly Documented?
Among the key issues is the validity of the account balance. An invalid account could lead to legal problems and may also harm the patient-provider relationship.
The provider must make sure that all codes are right, that all payments from insurance companies have been properly processed, that all adjustments have been made, and that the amount of money that the patient owes has been calculated correctly. Documentation must back up every charge on the bill.
The review of accounts prior to transferring them to a collection agency will help detect billing mistakes that may cause problems.
Has the Patient Been Given Clear Communication?
The patients need to know what they owe. It is important for the doctors to ensure that their patients understand their responsibilities financially before sending out the bills for collection.
Proper communication always motivates people and avoids bad behavior once the bills are sent for collections. The practices where patient education is prioritized face less opposition and better results from collection.
Does the Collection Agency Understand Healthcare Billing?
All debt collecting companies do not have knowledge in medical billing. Medical claims have special requirements when it comes to regulations, insurance coverage, and patient confidentiality. The doctor needs to know whether the agency is experienced in dealing with healthcare cases and whether their employees understand medical billing rules.
In such a way, a medical debt collector will be able to provide more professional communication with the patient.
How Will Patient Relationships Be Protected?
The reputation of the doctor is dependent on how good his/her relationship with the patients is. Although aggressive approaches will enable the recovery of money, they can create an image problem that will lead to unfavorable reviews.
The doctor needs to know how the agency communicates and what its collection policy is. There should be a balance between being assertive and professional.
The approach adopted by the collector should reflect the value system of the medical practice.
Is the Agency Compliant with Relevant Laws and Regulations?
Collection procedures have a lot of rules that both federal and state governments provide. There may be some reputation and legal problems for physicians when their collecting agencies fail to comply with relevant laws.
It is essential for doctors to assess the compliance program before choosing an agency. An agency should prove its awareness of debt collection, privacy, and healthcare regulations.
Choosing an agency that complies will prevent possible problems.
How Is Patient Information Protected?
Medical debt collections involve the exchange of sensitive data about patients. It is vital to ensure the protection of such information in order to guarantee privacy and compliance with regulations.
It is important for physicians to know how an agency collects, distributes, and protects information about patients. In particular, the measures of data security should comprise data encryption, safe systems, access management, and staff training.
Physicians should also know what measures will be taken in case of any incidents with data. Such measures will ensure the security of data.
What Is the Agency’s Success Rate?
There are significant differences in the performances of collection agencies. Before making any arrangement, doctors should ask for information on the recovery rate of the agency
Even though the recovery rate should not be the only determining factor, it will give an indication of how productive the agency is.
What Fees Will the Practice Pay?
Collection firms normally make use of contingency charges, fixed charges, or a mixture of both types of charges. The knowledge of the cost structure is important to be able to determine whether outsourcing the collection of fees will yield any benefit.
The knowledge of the cost structure is important in order to compute the possible benefits that could be earned.
Can the Agency Provide Transparent Reporting?
Collection management demands visibility into the performance of accounts. Physicians need to be able to receive reports about their account performances in order to keep track of the performance of their agencies.
Reports help make informed decisions about the effectiveness of collections.
How Are Patient Disputes Managed?
Many times in health care, there will be disputable claims. They can arise from issues relating to insurance claims, billing errors or charges and can be handled by expert denial management
Before a physician sends out the account, he or she needs to know how the agency settles disputes. The collection agency should have procedures on how to handle the disputable claim.
This will prevent patients’ frustrations and escalation of disputes.
What Happens if a Patient Wants to Return to the Practice?
Most patients eventually become debt-free and will need to use services in the future again. Doctors need to think about the impact of collection processes on their ability to keep these patients in the future.
There are some collection companies that operate only for the sake of collecting the debt, and others concentrate on maintaining good relations with patients in the future. The doctor needs to know what kind of company it is.
It can be useful for patients and doctors.
Conclusion
The decision of transferring patient accounts to the hands of medical coding company play a big role in the success of the physician. This is why physicians need to look into their collection process before making this decision, as well as assessing patient communication practices and potential collection partner choices.
Through proper questioning about such aspects as compliance issues, security measures, performance, commissions, reporting requirements, and patient handling, doctors will be able to make sound decisions regarding medical debt collection. It will not only help increase the effectiveness of the debt collection process but will also protect their good standing in the future.
