Medical groups become more aggressive with patient debt collections

Many physicians and medical groups are aggressive in the way they collect debts from their patients, who also struggle with rising out-of-pocket costs, Kaiser Health News reported.

Mid-State Orthopedic and Sports Medicine Center in Louisiana collects payments before treatment begins and bases the size of staff bonuses on how much they collect. In one instance, it asked shoulder surgery patient Gayle Jackson-Pryce to pay $831 prior to the procedure. That money represents her out-of-pocket cost owed to the practice's orthopedic surgeon after the deduction of insurance payments. The practice uses its computer system to determine exactly what the patient will owe.

If Mid-State can't collect the entire payment upfront, it will work out a payment plan. If the practice can't arrange a payment plan, staff will refer the patient to a local safety net provider, which might offer the treatment as part of its charity care program.

"We have to be able to be the creditor," Spencer Michael, the group's administrator, told KHN. "We're essentially a bank at that point." The practice will soon make payments more convenient by allowing patients to use tablets with credit card swipers attached.

One of the other ways hospitals can improve their collections is by communicating with patients and giving them every opportunity to pay.

The Great Recession, combined with higher out-of-pocket costs for insured patients, caused multi-specialty group bad debt to increase by 14 percent between 2008 and 2012, according to data from the Medical Group Management Association (MGMA). As a result, providers are more assertive in collections. In addition to trying to collect more upfront payments, they are also more assertive in post-treatment collections. More practices refer patients to collection agencies within six to eight weeks, as opposed to six months, Ken Hertz, a consultant with MGMA, told KHN.

To learn more:
- read the Kaiser Health News article