Recently, Part B News reported on some new ways to improve patient collections in the physician practice setting. We also discussed the subject with Joe Clark, CEO of Sierra Pacific Orthopedics in Fresno, Calif., from which the following is excerpted. He told us, among other things, why Sierra Pacific Orthopedics doesn't take advance payments, how he runs his credit card on file, how he reduced his 90-day A/R by more than 60% and the secret to effective staff-patient payment communications.
Joe Clark: Eventually, we hope advances in connectivity and technology will allow practices to accurately calculate, in a timely fashion, patient responsibility immediately after the patient visit. [But currently] in orthopedics, there are too many variables to predict what procedures, tests [and] treatments we will do during a patient visit to even come close to estimating patient responsibility at the time of service
We’re not lenders; we don’t assess the credit-worthiness of our patients. I just saw a specialist and was asked to pay when I checked in, even before the physician had seen me, done his E/M coding or ordered and performed additional testing. [If we did that] we’d be collecting in advance, and then refunding -- and we don’t want that.
We have adopted InstaMed’s Auto Payment Collect process, which isn’t anything new -- historically, this has been known as credit-card-on-file program. Both my kids had braces, and my card’s been on file with the orthodontist for years. After the service is done, we contact insurance, they adjudicate, and then we send the patient a seven-day notice that we’re going to change their card.
We rolled this out three years ago. We still have 10-15% of patients who don’t have the money on their card or who cancel their card when they leave. But we’ve reduced our 90-day A/R by more than 60%.
We do our best to educate staff and verify their understanding of what was discussed. One important piece, which is new to us, is [that] we work with a firm on patient interaction -- Venel, a marketing company for orthopedic practices that also does web design, patient service training, etc. They provide new employee training videos so our messaging remains consistent throughout the practice.
Probably most importantly, we do role-playing with the staff, as if they were talking to patients. We find it beneficial because sometimes staff say what they think they’re supposed to say, but find themselves getting lost and not saying it as we have scripted.
[For example], when we listened to [patient] calls, we found that when our staff stayed on the script, there was no issue; but when they went off script, many times the patients were not understanding the benefits of the process and may have become confused, and the call would tend to degrade from that point forward. So staying on script is important.
Check-in and check-out staff tend to have higher turnover ratios within a medical practice. For this reason, it is important to continually train, listen to interactions with patients and train again.