As I complete my fifteenth year as a solo medical billing service,I find this year the most difficult one for patients suddenly without insurance. Over the years I have seen cycles where patients are forced onto Medicaid plans for a period of time but then move back to managed care due to re-employment or they become eligible for Medicare. While I always have some balance bills for patients who “refuse” to pay their portion under the terms of their insurance, this year is different.
There are now stacks of balance bills for patients who are unable to pay. Many of these patients have been seeing the same doctor for years (primary care or a specialist for a chronic condition). Some patients doctor hop to spread the debt around.
Some patients come in with expired insurance and if eligibility is not checked, the patient gets a free ride at least for a while. Some patients might give a check that will be returned for insufficient funds while others may think twice about using a credit card should your office accept that form of payment. Some people will simply ignore the bill because they are overwhelmed with all the other bills, so what is one more?
Now is the time to set policies for patients who have no insurance. Certainly checking eligibility makes sense even in better times. A partial payment can be advised while making the appointment and if you take credit cards, ask the patient if you can expect him/her to use it. Set up a payment plan at the end of the visit and keep one employee or your billing service informed of the arrangement. Make notes in the computer as to what was discussed. Consider a courtesy on a case by case basis especially if you can obtain payment in full at the visit. This saves time, creates loyalty, and a good feeling among the staff who collected the money.
You know your patients best and when they hopefully obtain insurance again, do you want them going to another doctor who might have been more flexible during this rough patch? Is a collection agency really the answer that may take a portion that is larger than the courtesy you may give? Most people want to pay their bills; be clear on what you are billing them for and communicate your policy with your patients
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