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 By Neil B. Gailmard, OD, MBA, FAAO, Editor October 2, 2002 - Tip #37 
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Asking for money

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Do you ever feel like your accounts receivable is too high? Does your staff complain that patients do not understand their vision plans? Do you often find yourself transferring a balance back to the patient because their insurance did not pay? I have had all these problems at times in my practice, and the best thing I ever did to control it was to change what my staff tells people over the phone - when they call to make an appointment.

I believe you can set your policies on billing and insurance participation to whatever you like, and it will work out fine as long as you tell patients in advance what is expected of them. Further, I think patients want to know what the fees will be and when they will be expected to pay - and they have a right to know! By taking the mystery out of fees and payments, my practice appears more patient friendly and has taken better control of our collections.

My motto for collections is... never ask for money without telling the person in advance that you are going to ask for it. My staff asks patients over the phone if they intend to use any insurance plan for their upcoming appointment. After hearing the answer, we state our exact exam fee, explain our participation with that plan, and let the patient know if the fee will be payable at the time of the visit. We do not want someone standing at the front desk after the exam, expecting to have the fee covered by an insurance plan that we don't accept. Nor do we want someone to assume we will send them a bill.

I know that the preferred strategy for years was to not quote a fee over the phone - at all. Or to evade the question by saying it depends on what tests are needed. Or perhaps quote a range of fees. I suppose the thought was that potential patients might not like the fee, and might balk at making an appointment. In truth, I would rather have them balk then take my time and not be prepared to pay. I have not found it difficult at all to set one standard comprehensive exam fee, which applies to almost all new and yearly visits. Interim follow-up visits and other special testing can be quoted in the office in person, since they follow the comprehensive exam.

If the patient orders glasses or contacts after an exam, we explain these charges and what is covered by insurance and what is not. We always explain that we need a 50% deposit to place the order, and that the balance is due at dispensing. There are no surprises because we do this 100% of the time. My staff is instructed to never come to the doctor with special requests for payment plans. We simply don't do it and the staff knows this so well that there would be of no point to ask. We do accept major credit cards.

Patients don't take offense that we tell them what the fee is and when it will be due. They seem to appreciate it. They know our services cost something and they expect to pay it. Talking about fees has become such second nature to my staff that it feels perfectly natural. In-office collections are never a confrontation or an embarrassment - if you do the work on the front end.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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