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Archive June 2016 XVII, No. 6

Coding & Billing: Collecting Co-pays on the Day of Surgery

6 keys to an effective patient collections program.

Prerna Gupta

Prerna Gupta


patient payments PAID IN FULL Strive to collect 100% of patient payments on the day of surgery to limit your exposure to bad debt.

Are you collecting every dime of what patients owe on the day of surgery? If you're not doing so before patients go back to the OR, you're likely leaving significant money on the table.

In this era of high-deductible health plans that are forcing beneficiaries to cover higher co-pays and deductibles of $1,000 or more, patient collections can account for 20% to up to 40% of revenue for surgical facilities, according to some estimates. Yet collecting from patients on the day of surgery is not an easy task. Patients often assume that once they pay their premium, there won't be any additional charges for their surgical care. What typically happens when you send these patients a statement after treatment with a patient balance on it? That's right, they often ignore the debt, and hope you — and it — will go away. Here are some strategies to get patients to pay up in full and on time.

Stay ahead of the game. Don't get stuck in a cycle where your billing office has to play a game of catch-up to collect patient payments. Instead, have the front office do the legwork before a patient undergoes surgery, verifying insurance benefits and calculating what patients owe days in advance. Be sure at least one member of the front-office staff is properly trained on how to verify patients' insurance. Once these staffers know what's owed ahead of time, they can inform patients of their responsibility during the pre-op phone call, which can also give the patient the opportunity to set up a payment plan or try other options, like third-party financing. When patients present for their procedures, your business office will have a much greater chance to collect 100% of the co-pay and deductible. By securing a patient's payment on the front end, it will be easier for you to reduce your cost to collect delinquent payments, and eventually reduce your exposure to bad debt.

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