Dos and don'ts for managing self-pay collections

Last week, FiercePracticeManagement reported live from the Medical Group Management Association annual conference in San Antonio with advice from Elizabeth Woodcock, principal of consultancy Fredericksburg, Va.-based Woodcock & Associates, on how to focus your practice's self-pay collections efforts. Woodcock provided too many valuable tips to share in one article, so here are several more important dos and don'ts she provided during the presentation.


  • Do boost your financial controls.
    If you succeed in taking in most of the money you should at patients' time of service, your practice could potentially be collecting thousands of dollars more over the counter than it was previously. This much cash passing hands opens up the opportunity for dishonest employees to commit internal fraud, Woodcock said. To safeguard against the risk of embezzlement, make sure you establish and follow robust internal controls.
  • Do use pre-employment competency testing.
    Up to 70 percent of job candidates lie on their resumes, Woodcock said, adding that "anybody can look good during a 30-minute interview." But newer requirements of medical office employees call for hiring employees who possess certain skills, such as using certain technologies or being able to calculate 20 percent of a number to determine a patient's coinsurance.

    "It's been built into medical practice culture that we have to wait until a balance is 120 days past due to ask for money, but there's no reason to wait."

    Therefore, as part of your screening process, test candidates on how they would handle specific scenarios in your practice. For example, you could hand the person a payer denial with all identifying information blacked out and ask, "What would you do about this?"


  • Don't take rescheduling lightly.
    While threatening to reschedule patients who aren't prepared to pay up may sound like an effective strategy, Woodcock cautioned against enforcing such policies, at least without discussing the issues of patient abandonment and dismissal with your malpractice carrier first.

    "I worry about the medical-legal risk to put it in the hands of a [non-clinical] staffer to refuse to see a patient," she said.
  • Don't wait until balances are past due to collect.
    "It's been built into medical practice culture that we have to wait until a balance is 120 days past due to ask for money, but there's no reason to wait," Woodcock said.
    >> Check out FierceHealthFinance's special report on "Patient Collection Best Practices"

    Rather, instruct staff to hand a current statement to every self-pay patient owing a balance before they leave the office, she said. To boost collections even earlier in the revenue cycle, consider having schedulers inform patients of their exact balances at the time they call to make an appointment. Even if the patient doesn't pay off the balance with a credit card during that phone call, he or she will know the practice has an expectation that it will be paid on the day of the office visit.

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