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Maximizing Patient Co-Pay Collections

Posted On April 11, 2014
Maximizing Patient Collections
April 11, 2014

Maximizing Patient Co-Pay Collections

Due to declining insurance reimbursements, it is more important than ever for physicians to have a strong front office co-pay collection policy in place. Improving co-pay collections begins with the practice leadership setting expectations. At our SATCOA locations if co-pays are not collected at the time of service, patients will not be seen, and will be rescheduled.

The problem is that many of the physicians and front office staff are uncomfortable asking patients for money upfront. With the patient now responsible for a larger percentage of health care costs, many providers do not want to cause friction. They do not want to upset patients by asking for co-payments at the time of service.

The Importance of Co-pay Collections

It is easy to overlook the importance of collecting a small $20 to $30 co-pay per patient when looking at revenue. However, if your staff is not consistent in collecting these charges or your practice does not have explicit written policies in place, you are losing thousands in potential revenue.

Consider this simple equation, if your average co-pay per patient is $25 and each provider sees approximately 25 patients a day that is $625 per day per provider. Furthermore, depending on the total number of work days, your co-payment volume could account for $125,000 per provider per year.

Co-Pay Per Patient Patients Per Day Number of Providers Number of Work Days Potential Revenue
$25 25 1 200 $125,000

Tips that Can Help Co-pay Collections

Here are some great ideas to help you create, implement or optimize your current patient collection system…without angering your patients.

Ask at the time of service. Everyone knows it is more cost effective to collect from a patient who is waiting in your office. However it is still an accepted practice to send out multiple bills, which depending on the balance may be written off. Industry figures cite a cost between $7 to $10 per billing notice when taking into account labor costs, printing and postage. In addition to this cost for collection, revenue cycle studies show collection rates from patients drop almost 20 percent after leaving the office.

Patient education. From the time an appointment is requested, it is important that the office staff notifies the patient that co-pays are due at the time of service. When patients check in be sure that there is a prominent sign in place explaining co-pays are required for service.

Refuse to see non-urgent patients. If your staff properly educates patients during appointment scheduling and your policy is clearly posted at the time of check-in, there will be less of an argument. Some patients will be frustrated. The best course of action is to have a provider or office manager explain that co-pays are part of the patient’s insurance plan and that it’s mandatory.

Collecting patient co-pays should be part of the routine for your entire office staff (including physicians). It should be viewed as important as verifying insurance coverage and scheduling appointments. Hold your staff accountably and motivate them to be professional and empathetic, but also to be consistent and firm. Each team member must understand that patient co-pays can make up a significant volume of total revenue for the practice. After all co-pays can affect everyone’s livelihood.

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