fix this practice
| RICHARD S. KATTOUF, O.D., D.O.S.
You Decide On Discounts
Be sure that both staff and patients understand your office collections policy.
Patients keep asking for discounts on services and materials. How do we handle this growing problem in our practice?
F.L. Perkins, O.D. Via e-mail.
A: First, I would suggest independent practices eliminate the word discount from the office vocabulary. This is a retail term. Replacing it with words such as savings, courtesy or professional discount will help refocus both patients and staff.
Getting the best deal
This issue is becoming very common throughout the country. The mentality of the patient (consumer) is to ask or look for a deal. Its interesting that many other health-care professionals would never consider extending professional courtesy to the general patient.
Optometry has a history of being a product-based profession. This history and an increase in commercial optometry practices are partly to blame for the discount dilemma. Many O.D.s are to blame as well for enabling their patients to seek discounts by caving in to these requests.
A client of mine has a specialty practice limited to pediatrics, developmental vision and brain-trauma patients. Dr. Harriett (name changed) doesnt accept any vision or medical insurances. His office bills the insurance companies as a service to the patients, but all services are private pay. The fees for a therapy program range as high as $4,500.
Prior to Dr. Harriett retaining my services, he had three payment plans, two of which allowed patients to make monthly payments. This doctors accounts receivable (AR) were out of control. When you enable the patient to pay per visit or per month, you put the patient in control of the program.
I advised Dr. Harriet to only offer services on a per-case basis, giving patients two options: pay the fee in full or borrow the money through care credit, a service that helps patients who have medical needs not covered by insurance (www.carecredit.com). This change in policy eliminated the high AR, raised net income and cash flow.
I composed an in-house script for his staff, should any patient ask for discounts, which explained the following points:
• The offices fee structure is reasonable for specialized services.
• If our office reduced the fee, it would be necessary to downgrade the professional services, which could result in unfavorable results.
• In order for our office to continue to render the best staff, facility, instrumentation and services, its not possible to lower the fee.
• If our office extends a courtesy to any patient, there will be a snowball effect with any of that patients referrals expecting similar savings.
Put it in writing
In my experience, the root cause of these problems is a lack of defined collection policies. Write them down in your policy manual, discuss them with the entire staff, and have all your employees sign the policy to indicate they fully understand it. The only exceptions to the policy is a short, pre-submitted list of patients who you have determined will receive the courtesy. The entire organization shares in the responsibility of the collection policies. You have heard me scold you in the past: Charge what youre worth. Stop practicing in fear of the patient, and dont be shy about fees!
DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES, OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM
. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.
Optometric Management, Issue: April 2007