Every webinar you listen to, any seminar you attend, and all the coaches you follow or work with will tell you collect on the first visit, collect every visit, and better yet, have the patient pre-pay. Is this ideal? Absolutely! Is this reality? Not usually.

When trying to decide what to write I considered themes like, “Top 5 Ways to Improve…” and “The 10 Things you should always do…”, but decided that the fundamentals of front desk collections really only consist of two things: procedures and head space.

PROCEDURES: Front desk collections should be a fundamental documented procedure in your office. Your processes need to be specific, consistent and outlined step-by-step in a manual. The procedure should be assigned to a specific person and follow a thought out timeline such as 30-day, 60-day, and 90-day procedures.

For example:

  • First visit: Always collect. Collect a set amount for all new patients on the first visit, verify the patient’s benefits before they leave to help you better determine what to collect, or at the very least ask them to pay the co-pay amount listed on the front of their insurance card.
  • Every visit: Always collect. Once benefits are determined and reviewed with the patient, collect their patient portion every visit. If the patient is being seen multiple times offer them the convenience of pre-paying for several visits in an effort to respect their time and busy schedules.
  • Patient statements: Print, review and send monthly
  • 30-day follow-up: Handwritten notice expressing concern on their patient statements
  • 45-day follow-up: Phone call and/or email
  • 60-day follow-up: Additional letter included with their statement
  • 90-day follow-up: Payment arrangement offer and/or further action notice (such as collections)
  • Payment arrangement process: How to pay, when to pay, what to pay
  • Further action/collection process: Who do you work with, when do you forward, how do you follow-up in your system, and how do they notify you of account status.
  • Hardships/Balance forgiveness: When are past due account reviewed for write-off, what is the criteria for consideration and who determines they should be written off. Is the write-off just done or is the patient notified.

This example is not a completed procedure; it represents an outline of collection processes. Each bullet point requires more specifics in terms of why do we do it (what is the goal of the procedure) who does it, when it is done, what is done/sent (with detailed examples), how is it documented and followed up on, and where is it documented. Include any scripts or pre-set forms that would apply to any of the processes. You will find that every person is different, what is common sense to you may not even be a consideration to someone else. It’s imperative that every part of the process be spelled out and include specific examples and/or formats.

HEAD SPACE: The greatest, most well thought out and documented procedures do not work if they are not followed. Head space is about ensuring your front desk collection procedures are successful. Talk about front desk collections within your team. Discuss why they are important to you as a business and why they are important to your patients.

Be realistic about business. The bottom line is no matter how much your goals and aspirations are to help people and change lives through chiropractic, you cannot do that if you do not make enough money to support your office, your family and the payroll of your team. Over the years as insurance coverage has increased patient portions more and more, front desk collections have become imperative to your bottom line. In the cases of high deductible and high co-pays, it is many times the only payment you receive for your services.

Be open to how not collecting effects your relationship with your patient. You are not helping your patients by not telling them what they owe when they owe it and what their options are for payment.

  •  Imagine if you went to the grocery store and there were no prices on any of the items, wouldn’t you be irritated? Wouldn’t you think, “how do they expect me to shop here if I don’t know what anything costs?” People want to know what is expected. Review their benefits with them and be clear on what you are charging and what their portion is estimated to be.
  • Imagine again going to the grocery store. Everything was marked with a price but when you got to the counter they bagged your groceries and didn’t charge you. Wouldn’t you be confused? After a few occurrences, wouldn’t you start to dread going to the counter, waiting for the day they presented you a massive bill for several trips? People expect to pay for goods and services until you teach them not to.

Openly communicate and include your team in what you do and why you do it. Even those who are the most uncomfortable with asking for money will do it when they understand how to do it and why they are doing it.

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