In today's economy and health care marketplace, chiropractic offices frequently face challenges when collecting co-pays, deductibles, co-insurances and other balances due from patients. Unfortunately, ignoring the problem only makes it worse. Learn how to set up some simple systems for collecting the right way, every time from your chiropractic patients.

It used to be that if you failed to collect money from patients, that you either lost out on income and/or created collections issues for yourself. Asking for money is now an absolute necessity for two reasons: 1) lost income and 2) failure to ask for money that a patient owes the practice could lead to a breach of your chiropractic provider participation agreement as well as potentially creating a False Claim to the insurance carriers.

Unfortunately, in the 80's, many chiropractors created a monster in that we allowed patients believe that their coinsurance was optional. I don't personally know any clinics that are still stupid enough to engage in this practice; however, the stigma still exists.

To make collecting even more challenging, some patients believe that you, the chiropractor, make enough money and that you do not need the extra $20 or $30 bucks. They claim financial hardship and proceed to drive off in their Lexus, while you are so undercapitalized that you give your practices loans to make payroll.

You want another laugh? Many MD's over the past few years have sought other ways to make up for lost revenues by adding ancillary services to their service mix. Take, for example, the Obstetrics and Gynecological practice that now offers weight management, laser hair removal or skin resurfacing. Interestingly enough, these services are paid in cash, in advance, before the services is even rendered.

What's worse is that some of the very same patients who are lined up to pay cash for these cosmetic services (which usually total in the hundreds or thousands of dollars) are the same patients who gripe and complain when it comes to paying their $20 coinsurance or their $250 deductible.

Certainly, I am not stating that there are not financial hardships. When you run across a chiropractic patient with a legitimate financial issue on hand, you should have written policies in place to handle that. What I AM trying to convey is to eliminate excuses that patients use for non-payment. In short, be very cautious about allowing your patients to dictate how you run your practice.

Doctor (and staff), Heal Thyself
Sometimes, we (and our staff) are the biggest threat to good collections.

Ever watch your Chiropractic Assistant try to collect a co-pay? I have some seen some staff members ask a patient to pay their co-payment and literally duck as soon as the words come out of their mouth so as not to be hit by a thrown object! Bad sign, my friend. Get that person away from the front desk.

Another common problem is the attitude we use when collecting patient copayments. What do you think happens when your staff says to the patient "Would you like to pay now or should we bill you? What on earth do you think they are going to say? "By all means, bill me!" Don't blame the patient. It's the attitude of your staff that is the issue - they are acting like payments are optional. Train this person quickly or liberate them to find another job.

The Biggest Collection Problem in the Chiropractic Practice
Where does the biggest source of collections problem typically lurk in our practices? The Doctors -- of course! What do most of us say when a patient gripes or complains to them about what they are having to pay out of pocket to come and see them? "Don't worry about it, I'll handle it!

If we heard one of our staff members say this, we would go ballistic; yet these very words spew out of our mouths frequently when it comes time to discuss money!

The Golden Rule for Collections
Ok, here is Tom Necela's "Golden Rule" regarding collections, you ready for this? Get your highlighters and pens ready because this is the pay-off for the entire article. Ready? Are you sure? Last chance to get the highlighter!

Here it goes, "Never let the doctor get involved with a patient face to face or on the phone over finances." Period. The end!

Doc, this is the beginning of the end for good collections procedures. When the chiropractor gets involved, it forever alters the physician/patient relationship and you can never get that back. In addition, this is where your billing manager and your staff -- who are charged with the responsibility of collecting from the patients -- get permanently discredited.

Yes, I said permanently. Why? You tell me, doc! If your well-trained staff tries to collect and YOU let the patient slide one time -- what's to prevent them from repeating the same behavior in the future?! Don't do it. Train your staff well, train them often, give them consequences for non-performance and performance based bonuses.

And then, let them do their job!

Chiropractic Soup Nazi Beware!
Now, I know there are those of you out there who say, "Not in my practice Cowboy!" We collect from EVERYONE! Although this is typically less of a problem, I do have to address the other "extreme" of collections.

I do believe there are offices that are a little too efficient at collections. There is also a problem with this. I have seen how some of your staff handle your patients collections and they are like Seinfeld's famed "Soup Nazi" -- no soup for you!

You have what I refer to as the "bull dog" sitting at the check out area and when a patient tries to leave without paying their portion they attack like a dog going after a piece of raw meat! You know the type, they will literally wrestle the patient to the floor before letting them slide on a payment.

I once was at a chiropractic clinic where I literally watched in amazement as an incredibly rude, mean, and just plain scary front desk C.A. frightened patients into paying. She was totally consistent, but the vibe was way wrong. In fact, one of the patients in the waiting room witnessed her behavior and joked: "These docs must be making a lot of money. They got a bodyguard at the front desk to protect them!"

Yes, these offices get the money, but it's bad for business, folks.

Find Happiness in the Middle
In short, collect everything you can. Give patients many possible ways to pay. Do this all while being nice about it and they will pay you.



Article Source: http://EzineArticles.com/?expert=Tom_Necela

The topic of outsourcing a chiropractic office's billing brings up much controversy in chiropractic circles. Although, there is no right answer for everyone, let's take a look at the issue in detail to find the best answer that may suit you.

The Issue of Control
Chiropractors who are big fans of keeping billing in-house typically cite "control" as a factor of why they are in favor of in-house billing. While it may appear that you have more control over your billing by having an employee who works in your office handling your claims, your employee may have too much control.

That is, they can get to know patients and let overdue accounts slide. They can dislike certain tasks (calling attorneys, for example) and decide to ignore them. One of the biggest negative of in-house control is the fact that when your biller is sick, goes on vacation or is doing less than a stellar job, they have effectively controlled your ability to get paid. "Control" is not always a good thing.

Are Employees More Sensitive to Patient Concerns?
Another common reason that I hear in defense of in-house billing is that they wish to be more "sensitive" to patient concerns. Yes, it is true that an outsourced biller who is paid on a percentage of collections may not really care whether Ms. Jones can truly afford her co-pays, mainly because the biller does not know the patient. Billers want to collect - period. And when Mr. Smith's claims go straight to the deductible, again, the billing agency wants to be paid.

Again, look to the bottom line here before you conclude that you need this sensitivity from your billing department. Generally, these are the exact types of situations that will get you into accounts receivable trouble in the long run and are easy temptations for the in-house biller who wants to be liked. Down the line, the little incidents that your in-house billing employee has let slide will cost you money.

Still On the Fence? More Reasons to Outsource!
Given the requirements of today's billing processes, it takes the specialized skill of a medical billing professional to be successful and compliant. Billing should not be something someone does to fill in the time between scheduling patients and pulling their charts.

A decade and a half ago, billing was much simpler. Payers changed the rules once a year and informed practices in plenty of time so they could adjust their processes. Denials averaged less than five percent of total claims. Today, it's not unusual to have a 30 percent or higher claim-rejection rate, which requires extensive follow up.

The challenges that internal billing operations are faced with on a regular basis can lead to collection shortfalls or non-compliance.

Here are some more reasons why outsourcing to a billing company makes sense:

• Regulations change constantly, which means that dedicated personnel must be assigned to read bulletins, interact with payers, and attend industry seminars.

• In large organizations, Billing and Coding are separate departments. Most chiropractic offices don't have the resources to dedicate personnel who have the responsibility for ensuring that documentation and coding is compliant with federal regulations should also be certified by one of the accredited organizations. Outsourcing may enable you to achieve this.

• Implementing and maintaining a compliance plan can be expensive for an individual practice; with a professional billing company, the cost of a compliance plan and the compliance officer can be spread across many clients.

• Technology is a huge cost center for an individual practice. For example, in addition to the initial purchase price of payment-tracking software to ensure proper payment according to the appropriate fee schedule, there is the ongoing cost of keeping payment tables accurate. Denial management tools are also required to track and eliminate the root cause of why denials are occurring in the first place.

• Lack of follow-up relating to unpaid claims is the single biggest problem I encounter when consulting with most chiropractic clients. Follow-up is burdensome and time consuming. Because it seems to be the last thing folks get around to, it leads to lost revenue due to the various payers' "timely filing" requirements.

• It is getting harder to attract and retain competent billing personnel. The Society of Human Resource Management states that the cost of recruiting, hiring, and training a new employee is $3,500. Utilizing a professional billing company eliminates this expense in its entirety.

• Professional billing companies offer economies of scale, which makes their services less costly than if a practice tries to run its own internal operation.

When Outsourcing Does Not Make Sense
As I stated at the outset, I do believe outsourcing makes sense most -- but not all -- of the time. Typically, outsourcing may not be the best choice from a financial perspective if your chiropractic practice is at one of two extremes.

For tiny practices who have very few patients or for practices that are mostly cash-based, outsourcing may appear expensive and time consuming rather than just doing it yourself or in-house. Use caution here to make sure you or your employee know what they are doing before coming to this conclusion.

The other extreme is very large practices. The typical percentage an outside billing company may want as a fee for their service may not make financial sense if the practice has a qualified employee(s) who may be able to be amply compensated to do billing full-time.

Again, use caution here in not trying to save too much. Sure, you can probably spend less on your employee's salary than you may have to spend with an outside billing company. However, remember the issue of follow-up. Is your staff going to be able to handle it? If not, the extra money is worth it.

KEEP YOUR GOALS IN MIND
When looking at the big picture, it is important to keep the ultimate goal in mind.

For most, the goal of any chiropractic billing company is to maximize collections and ensure compliance. With the plethora of regulations that now affect billing and collecting, practices need full time professionals to handle their billing.

Today most chiropractors are working harder than ever before and making less due to additional regulations and declining reimbursement. The question they should be asking is, "Why should I have the additional burden of running a billing operation?"

As you can see, there are many good reasons to outsource your chiropractic billing and, likely, the scales are tipped in favor of outsourcing. Either way, now you can make an informed choice!



Article Source: http://EzineArticles.com/?expert=Tom_Necela