Front desk collections are a key component of a profitable healthcare office, yet, they are often one of the most overlooked areas. Many offices rely almost solely on insurance collections, often overlooking patient collections. 

When done right, patients are easy to collection from. I'm going to show you how I walked into an office and within two weeks, had 10xed their patient collections WITHOUT increasing new patients. ​

Ready? Here we go:

Step 1:
Make sure someone is there to collect.

I know that sounds simple, however it's often overlooked. Have someone at your front desk who's job it is to collect patient co-pays and balances. I've seen many a front desk that have staff sitting there but do they know it's their job to collect? Do they make a point of collecting from each patient with a balance?

Just about the worst person you can have at the front desk is a doctor who doesn't like asking patients for money.  Listen, I get it. You're there to help. The money isn't your thing. Then don't sit at the front desk! 

Put someone at the front desk who isn't afraid to ask for money. Don't let anyone who is inclined to say "don't worry about it" sit at the front desk. 

Step 2:
Ensure they know WHAT to collect.

Seems simple enough but poorly done insurance verification, backlogged EOBs and confusing software can all make this task impossible. ​

If the insurance verification is done incorrectly, you won't know what to collect. 

If the EOBs are backlogged and not entered into the software, you won't have current balance information. 

If your software has no place to remind you that the patient has a $20 co-pay of if the front desk can't access it and doesn't know the last visit went to deductible and the patient now has a balance, you won't have efficient front desk collections. 

As a side note, trying to collect money the patient doesn't owe can upset the patient and makes your office look unorganized. This happens when patient payments that were already made are not entered into the software in a timely manner. 

If your revenue cycle is in good shape, none of the above should be happening.

Step 3:
Make sure they are asking for the money. 

Again, super simple but you'd be surprised how many people have a problem asking someone to pay for something. Just make sure your front desk person doesn't have any backoff asking someone to pay for their visit. And don't let anyone who doesn't want to ask for money sit at the front desk.

Step 4:
Send patient statements! 

Sometimes not everything can be collected at a the front desk. Maybe the flow of your office, software or billing service makes this a little harder. That ok IF you are sending patient statements in a timely manner. 

Don't wait 6 months or a year to send statements. Putting too much time between the visit and the statement decreases your chances it will get paid. 

Waiting until a large balance has accrued is likely to upset the patient, make payment that much more unlikely AND stop the patient from coming into the office for future treatment. 

Healthy patient collections is a team effort that consists of several different factors running efficiently. 

If your patient collections need improvement, check out my "Maximizing Front Desk Profitability" Course. 

#1. Check your denialsDenials come in at two levels: the clearing house and from the insurance company (on the EOBs). Now is the time to go over the denials that may be coming in at either level and fix them at the root. The daily billing department actions would dictate that you handle the denials and resubmit, but what I am talking about here and looking for the TYPE of denials you are getting and trace them back to the root cause. 

For example: Frequent coverage related denials usually indicated a problem at the insurance verification level OR it is a LCD related issue. 

Another example: Too many demographic denials means someone is overwhelmed or not paying attention. Now would be the time to trace that down and assist that employee to do better. 

#2. Review your coding and LCDsAs mentioned previously, not knowing your insurance companies LCD can result in a lot of uncovered services. Now is a good time to review the LCDs again and pass them onto the staff to review as well. Note any changes for the new year. 

Same goes for coding, make any needed changes to fee slips, etc that may be applicable for the coming year. 
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#3. Tackle your A/R reportWould you be surprised if I told you I often encounter doctors who don't even want to look at their Accounts Receivable report? It's true. Sometimes the fear of just how bad it is can stop us from wanting to look. Like, when you don't check the mail for days because you know all you'll find is bills. 

However, as uncomfortable as it might be, now is the time to take a look and make a plan to get it tackled in the near year. 

Some things to keep in mind:

• Note the timely filing deadlines of your insurance companies and start with the stuff closest to passing this deadline. 
• A consistently high 60 day A/R is not a good sign. A/R should drop during this time period. If it isn't, your billing department needs help. 
• A high Patient A/R is a sign that financial matters with patients are not being handled correctly in your office. Patient A/R should never be high. 

In summaryThe new year is a great time for a fresh start. Taking on the above three points can make a huge difference in getting your office off to the right start in 2019! 

What happened??

Were you completely wrong when you hired them? Did you assume experience that wasn't actually there? Were you just so desperate for help that you possibly overlooked some red flags?

Maybe. It's possible all of that occurred. What's more likely, however, is you were not equipped to support the employee as was needed. 

Here's what happens:

Super gung ho Sally begins work on January 1. She's got the certification, she even has some experience and she's ready and willing to work hard. She dives in and begins to tackle your office the way she would have tackled a previous office. Maybe she's really. really good and 90% of what she does actually makes sense for your office. But what happens to that other 10%? It flies back and hits her in the face. 

That 10% is some part of her day to day work that she doesn't understand. She doesn't know how what she has been taught fits in to how your office actually works. Or maybe something in the industry changed and she doesn't have her wits around it yet. Totally common, right? No big deal?

Wrong. 

It's a big deal because Sally, feeling like she SHOULD have known what to do, hides the fact that she didn't know. She feels guilty, like she isn't doing her job. Each time she runs into something like this she has a little failure. These failures compound one on top of another until Sally doesn't like her job anymore. She feels like she has to hide her shortcomings and like she doesn't quite have her wits around everything she should be doing. Come June 1 Sally is disgruntled, not in very good communication with her fellow employees and contemplating taking a "less stressful" job. n

Let me clarify something: Sally is, most likely, NOT a bad employee. Sally is a completely NORMAL employee in an ever changing, confusing industry. Sally is an employee who never quite figured out how to reconcile what she already knows with how YOUR office works. Add to that the industry changes and day to day random problems that crop up and Sally feels like a failure. 

So what do you do about this? How to do prevent this "dwindling spiral"?

The answer is simple and it's two-fold:

1.) Training
2.) A safe space for Sally to ask questions and get information without fear of losing her job because she's asking something "she should know". 

New employees need to be trained, no matter how much of an "expert" they were when you hired them. 

Employees also need a way to continue to get corrected, get better and get clarified on their jobs and functions without fear that their question is "stupid" or something they should already know. 

So, if you find yourself wondering why your employee seems to be worse off than when you hired them, you have your answer. Find the areas they don't fully understand and get them cleared up. You'll have a happier employee in no time. ​