This document discusses best practices for medical practices to collect unpaid account balances from self-pay patients. It notes that the number of uninsured and underinsured Americans is rising, leading to more unpaid medical bills. It recommends that practices automate account balance reminders by phone, email, and mail rather than relying on manual collection methods, as automated reminders are more cost-effective and ensure consistent follow up with patients. The document also provides an overview of a company called Webley that offers an automated account balance reminder service for medical practices.

1. How to Collect Account
Balances from Your Patients
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2. Practices Collecting Directly from Self-Pay Patients
• Rising numbers of uninsured & underinsured in U.S.
– 47 million Americans (15.4%) are uninsured (CDC National Center
of Health Statistics)
– 25 million Americans are underinsured
• More is paid out of pocket as deductibles and co-pays for
employee sponsored plans continue to rise
– Employees need to contribute more for health care
– Dependent coverage cut
– High deductible health care plans gaining popularity
• Bad debt on the rise
– Health care bad debt is at record levels
– U.S. hospitals have $40 billion in unpaid patient bills (MSNBC)
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3. Medical Billing vs. Medical Collections
• The world of medical coders and billers
– Coders are responsible for accurate coding of claims, they may
audit and re-file appeals of claims
– Billers gather information from patients & physicians, ensure that
insurance forms are completed and signed, submit claims to
insurance companies for reimbursement
– Billers provide invoices to patients
– Billers track payment process to ensure payment is received, they
may handle patient inquiries
– Billers sometimes contact patients about past due accounts
• Collections not emphasized
• If using an outside firm that charges per claim, they have little incentive to
pursue past due accounts
• Be wary of billing companies that own or have affiliate relationships with
collection agencies
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4. Most Practices Mail Bill Reminders
Source: Webley research, 2009 survey
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5. Success of Medical Practices at Bill Collections
Source: NaviNet, 2009 survey of medical practices
N = 1279
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6. Concern Over Payments
• The McKinsey Quarterly estimates that 40% - 50% of patient
accounts receivables are uncollected (June 2007)
– 50% to 70% of small dollar liabilities for insured patients are
collected
• “The number of physicians who said they were concerned with
collecting from self-pay patients and those with high-deductible
plans and/or health savings accounts rose from 50% a year ago to
60% this year.” (MGMA 2009 survey)
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7. Challenges of Internal Bill Collections
• Patient privacy violations could lead to fines
– Fair Debt Collection Practices Act
• Could get in trouble for calling someone at their place of employment or
discussing the debt with third parties, other than the person’s spouse or attorney
• Slow, time-consuming, uncomfortable for office staff to
make calls about account balances
– Patient may not have privacy during call to speak about the
situation
– Staff has to deal with excuses, evasions, etc.
– Calls aren’t consistently made
• Easy for patients to ignore or overlook mailed statements
– Phone calls more effective at getting attention
– Mailing statements is expensive
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8. Bill Collections is Effortful but Necessary
Source: 2008 McKinsey consumer healthcare payment survey
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9. Best Practices of Bill Collections
• Clear payment & collections policy communicated to
patients
– Post on website, at your practice, on patient statements
– Remind patients when scheduling the appointment
• Have new patients or patients you haven’t seen for awhile
contact insurance verification department
• Collect at the time of service whenever possible
• Provide prompt billing & easy to understand patient
statements
• Late fees or charging interest on outstanding balances
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10. Best Practices of Bill Collections
• Make it easier to pay
– Online bill pay
– Accept debit cards
– Accept credit cards
• A client of MBA HealthGroup went from collecting 15% of
co-pays at the time of the visit to 40% after accepting credit
cards
• According to an article in the American Medical News (June
22, 2009): “practice management consultants say the option
of credit cards is well worth the cost of transaction fees,
compared with issuing paper statements and dealing with
the hassles and costs of bounced checks.”
• See privately insured on a cash only basis
– Lower administrative cost because patient handles
submitting the claim
• May want to consider using collections agency
for accounts over 90 days old
– Choose a collections agency with healthcare
experience
– Agencies charge .33 per $1 collected and only
collect 14% of the total amount due)
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11. Best Practices of Bill Collections
• Send payment reminders
– Contact those with outstanding
balances at least once a month (30,
60, 90 days)
– Automate account balance reminders
– Combine phone and mail reminders
to reach more patients
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12. Cost of Account Balance Notifications
Manual Automated Savings Qty/Month
Phone Calls $0.55 $0.15 $0.40 ?
Postcards $0.50 $0.15 $0.35 ?
Letters $1.00 $0.15 $0.85 ?
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13. How Webley MD Reminders Work
Create file of patients
with outstanding
balances
Campaign reports are Log in online, send
generated data to Webley
Messages sent to
Personalized
patients by phone, by
messages generated
email
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14. Webley MD User Interface
2 simple steps and your work is done
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15. Account Balance Script
“This is a message from Dr. Smith with important
information regarding the status of your account.
Please call us within the next 24 hours at (123)
456-7890 during regular business hours to
discuss this important matter. Thank you for your
assistance.”
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16. Benefits of Automating Account Balance Reminders
• Cost & labor savings
– Save on postage costs
– Save on labor
• Easier & faster to remind patients
– With consistent reminders, more patients will pay, shorter A/R
cycle
– Fewer accounts will go to collections agency
• Improved staff & patient satisfaction
– Fewer calls to make about payments
– Patients will call in ready to discuss their accounts
– Frees up staff time for patients
– Frees up phone lines, reduces phone tag
• Reduce exposure to legal liability
Better cash flow, increased office efficiency
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17. Webley Corporate Overview
• Founded In 1997
• Industry Pioneer in Advanced Speech Applications:
• Unified Communications
• After Hours Messaging
• Broadcast Messaging
• 7 Advanced Speech Patents
• 50,000 Active Customers
• Delivering 180,000,000 Transactions Per Year
• Fully Redundant Data Centers
• Numerous Awards For Technology Product of the Year, including:
Recipient of 2009 Product of the Year Award for
Webley MD Reminders from Customer Interaction
Solutions Magazine
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18. For additional information:
1-877-7-WEBLEY
info@webley.com
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