Optometric Management Tip # 146   -   Wednesday, November 03, 2004
Making in-office collections a snap

Continuing with last weekís tip about asking for payment at the end of a patient visit, I have another rule that my staff is trained to follow implicitly. This is not a rule we just give lip service to; we really do it. And the rule fosters excellent cash flow, smooth patient relations, and low accounts receivable. We never ask a patient to pay something unless weíve told them in advance. Think about that one and consider if your office also follows that rule and whatís involved in making it happen.

Iíve found that patients really appreciate what they feel is a courtesy when we tell them about fees and payment expectations. We are being considerate by telling them something important that they might not think to ask about. This rule prevents any embarrassment or hard feelings when itís time to ask for payment and it lets the patient obtain the funds in advance.

We never have a patient at the front desk who is not prepared to pay when asked. We never have a patient at the front desk who thought we would accept his insurance when we do not. Because all staff members universally follow the rule, weíre never in doubt about whether the patient was informed or not Ė we know he was.

This procedure of advance fee discussion was not very hard to implement, but possibly the biggest change is communicating the information over the phone when an appointment is scheduled. Letís look into the steps that a receptionist would go through.
  1. After setting up the time and date and obtaining all the usual information for an appointment, the receptionist asks the patient if he intends to use an insurance plan or Medicare.
  2. If he states a plan that your office accepts, tell him that you are a provider for that plan and that youíll need his plan ID number to verify benefits. If the patient does not wish to supply the needed information, you will have to treat him like an out-of-network patient since you canít verify coverage Ė see number 3 below.
  3. If he states he wants to use a plan that you donít accept, advise him that you are not a provider for that plan, but that he can pay your fee and file his own claim for reimbursement. This is usually acceptable, especially if the patient was referred to you and has already decided to use your services. And, if itís not acceptable, now is the time to find out! State the typical exam fee amount and mention that it is due at the time of service. If you must state a range, do so now, but itís better if you can actually pin down the actual fee for this first visit. You should state that contact lens services would be additional, and discuss that if applicable.
  4. If he states that he has no insurance, state the exam fee and payment expectation as stated above.
Additional fees for special diagnostic testing, eyeglasses, and specific contact lens materials and can be discussed in the office in person, since the patient will have the chance to say yes or no at that time.

If all this seem like we focus on getting paid too much, we donít. Itís the focus of this article, but itís only a small part of our interaction with patients, and itís a part they want to know about. We are careful to always focus on the patientís needs Ė not ours.

The steps over the phone may seem like a lot to cover, but Iíll wager that this is work your staff will happily and consistently want to perform. After all, they are the ones who must face the payment problems at the front desk.


Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management