Stamp out copay collection troubles
Script teaches front office staff efficiency and tact
What support staff couldn't use some tactful yet effective ways to ask for copayments? In emergency and outpatient departments as well as doctors' offices, these folks serve as the collection agents for a considerable portion of your revenue. It's a tough job for which few are trained. And they're an easy target of hostility from patients who resent having to pay. To make matters worse, many of the techniques handed down by senior associates actually invite excuses for late payments.
Since copayments are required in up to 80% of health care appointments, it's worth preparing your people to collect them with a degree of tact and efficiency, says Yon Regan, Denver district manager of Transworld Systems Inc. The training method he suggests is a question-and-answer script for expediting payment while letting patients save face when they lack the money to pay immediately.
First, you'll need a prop - a well-worn purse slated for giveaway. Fill it with equally tired-looking contents: An old lipstick, compact with a broken mirror, wallet bulging with defunct credit cards and tattered notes. Don't forget the keys from your old apartment and the car you sold three years ago. Most importantly, tuck a few commemorative first-class postage stamps in a pocket of the purse. This purse will become a permanent fixture under the front desk, and an essential part of your new collection strategy.
Now, the script:
Staff: Mr. Jones, your copayment will be $25 for today's appointment.
Patient: Oops, I forgot my checkbook.
Staff: (Immediately breaking eye contact and returning to computer keyboard or reaching for credit card slips, staff indicates to patient that alternative collection procedures are in place.) Oh, that's all right. We'll take a credit card, and I'll write your receipt right now.
Patient: I left my credit card at home today.
Staff: Here. Let me give you an envelope so you can mail us a check (hands over pre-addressed envelope with no return postage but takes it back just as patient reaches for it).
Ah, let me put a stamp on it for you (shuffles through papers on desk, in drawers, asks co-workers where stamps are; no stamps are to be found).
(Staff grumbles.) You'd think they could afford to keep us in stamps! Here. Let me give you one of mine (pulls prop purse out from under desk, takes off stamp, glues it to envelope, hands it back to patient). There, you can put your check in tomorrow's mail, and we should have it in three days.
Many patients believe that all doctors are filthy rich and that health care institutions overcharge for services, Regan says. "While some providers gouge," he allows, "the majority don't. Besides, patients don't have any idea of how much overhead providers pay just to stay in business."
"But the stamp trick doesn't even let the patient go there," he explains. While an angry patient wouldn't mind beating a doctor or a hospital out of a few dollars, he or she would probably think twice before wasting the perfectly good stamp from the receptionist's personal supply.
"For the 99% of patients who do pay their bills," he notes, "this technique will speed up their payments and reduce your accounts receivable." He adds that for the basically honest souls who "forget" the checkbook and credit card because they're short of funds, the stamp trick lets them save face while conveying the message that immediate payment is preferred.
When the credit card and mail-later offerings force the moment of truth with those who are short of funds, avoid the typical response, "Well, how much can you pay?" That, says Regan, lets the patient set the terms. If he or she opts to pay $5 or $10 a month on a $50 balance, you can see what that does to your collection expenses. By simply changing the way you ask the question, you can shorten the time the bill stays in accounts receivable. Here's how to do it:
Staff: How much short of the $60 are you?
Patient: All I have is $30.
Staff: (Maintaining eye contact, which invites an honest response, staff holds patient's attention until solution reached.) We'll take that much today. And how often do you get paid?
Patient: At the first and middle of the month.
Staff: Very good. We will bill you for the balance the middle of this month.
"It's more hassle to bill patients when they get paid than to bill everyone the same day," Regan admits, "but it reduces your accounts receivable if people get their bills close to payday."
While you might choose to revise or rewrite this script to suit your facility, the exercise of doing it and training the staff to use it gives them a set of tools they can fall back on to steer clear of the pitfalls of asking patients for money. As Regan puts it, "The script and the prop purse put an element of fun into it. It's a dance they can lead."
(Editor's note: For more insights on this subject, see "10 ways to cut unpaid medical billings," QI/TQM, May 1998, p. 65.)
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