The debt collection industry has changed significantly over the past ten years. The impact of technology on debt collection practices, industry consolidation

1. COLLECTING ACCOUNTS
RECEIVABLE
SUCCESSFULLY

2. Prepared for the
Southern Piedmont
Partnership for
Public Health
Incubator Project
Finance Focus Group
by Kathy Hartsell

3. TO BE SUCCESSFUL IN
COLLECTING
The process starts before the patient even
comes in the door.

4. EXPECTATIONS
Where do we get our expectations? From
our eligibility, debt management, fee, bad
debt write off and any financial policy
information forms that our patients sign.
Be sure patient knows what our
expectations are when appointment is made
and at time of eligibility.

5. HOW TO GREET A PATIENT
When a patient presents at the front desk
greet patients warmly.
Always acknowledge the patient.

6. THE INTRODUCTION
Good morning. My name is Melissa,
welcome to the Cabarrus Health Alliance, I
will be checking you in today.

7. MAKE YOUR PATIENT FEEL
COMFORTABLE
They may be apprehensive about being
here.

8. PRINCIPLES OF
COLLECTION
MANAGEMENT

9. COLLECT MONEY
BE:
Professional
Pleasant
Persistent

10. THE THREE V’S OF
COMMUNICATION
Verbal – 7% - What you say
Vocal – 37% - How we use our voice
Visual – 56% - What people see when we
speak words

11. COMMUNICATION IS
IMPORTANT
Tone of voice should be friendly.
Do not sound cold or abrupt.
Must be knowledgeable about your agency.
Must have enthusiasm.

12. ALWAYS SMILE
Whether you are on the phone or in person,
smiling has a positive effect on collecting
money.

13. EYE-CONTACT
When face-to-face, the look
in your eyes while
collecting should reveal
that you genuinely expect
that he/she should pay for
the service that was
provided.

14. BE PROFESSIONAL
Be courteous even when a patient gets
nasty.
Being too aggressive can hurt your
collection efforts.

15. BE A GOOD LISTENER
Always keep in mind that people are often
dealing with health issues and other
problems.
Express compassion for someone’s situation.
Never assume a patient is intentionally not
paying until you have taken the time to listen.

16. COMMON PROBLEMS THAT
CAUSE REVENUE LOSSES
Failure to collect patient’s
previous balances.
Not obtaining current
patient information.
Lack of, or inconsistencies
in collecting copays.

17. ELIGIBILITY
Must be done correctly to achieve
appropriate sliding scale.

18. INSURANCE
Must be verified before patient is seen.
Be sure to make a copy of the card front
and back.
Complete the insurance verification form.
Always verify who the insurance benefits
will go to.
Document insurance info in the PMS.

19. BE SURE TO COLLECT
THOSE COPAYMENTS
The cost of sending out statements for copays is
expensive and seldom results in collection. Small
amounts due are often ignored by the patient.
They assume the amount is an error or does not
want to be bothered to write a check, mail or use a
stamp for such a small balance.
Practices that do not collect copays are violating
their contracts with payers who require them.

20. MEDICAID
At each visit check the Medicaid card for:
Eligible dates
Managed care information
Insurance information
Change in recipient’s name
Month card was issued

21. WHAT IF THEY FAIL TO
BRING THEIR CARD
Enforce the need for patients to bring their
cards when they come in for services.
Verify SIPS

22. WHAT IF YOU CAN’T VERIFY
MEDICAID INFORMATION
Have patient bring in letter they received form
DSS confirming they are Medicaid eligible.
If you can not verify Medicaid eligibility, then
offer sliding scale fee. If no proof of income
patient will be placed at 100% until verified,
except for programs or if your policies that state
you will accept declaration of income.

23. ASKING
PATIENTS FOR
MONEY

24. HOW DO YOU ASK FOR MONEY
When a patient checks out, tell them
amount owed and ask if they want to pay by
cash, check or credit card, then wait for
them to reply.
Do not say another word!
The collector’s adage:
The next person who speaks, loses!
So let them speak next.

25. “I’VE NEVER HAD TO PAY AT THE
TIME OF SERVICE BEFORE.
WHAT DO YOU MEAN I HAVE TO
PAY TODAY?”
What would you say in response?

26. “I CAN’T PAY IN FULL” OR “I
DON’T HAVE THE MONEY”
“Our program services are based on a sliding scale
fee to reduce your fee based on your eligibility
and this is what you are expected to pay” Review
eligibility with them.
“We do accept credit card payments”.
Negotiate with them “If you pay half today, we’ll
send a bill for the balance due in 30 days.”

27. “SEND BILL NO MONEY
TODAY”
Were you not told you would be expected to pay
today? If they reply “no”. Apologize and give
them our expectations.
If you can not get money, get a commitment from
patient and follow-up.
Make notation in your patient management system
of this excuse.

28. SYSTEMATIC FOLLOW-UP
Example: “I will mail a check in two days.”
Your response should be to:
Call them if you don’t receive a check.
If you don’t, you lose credibility.
Remember, you are in competition with other
creditors!

29. DISCUSSING THE ACCOUNT
Get people to talk by asking questions.
Don’t ask closed in questions that only
require a yes or no answer.
Ask open end questions where they will have
to talk.

30. “HAVE A LOT OF BILLS TO PAY.
JUST HAD A BABY AND HAVE A
LOT OF HOSPITAL BILLS”
I understand you have a lot of bills to pay but ours
is just as important as any of bills you may have.
You are expected to pay on this bill.
(This is where you use your negotiation skills) How
much can you pay us?

31. WHAT IS A NEGOTIATION
Something you are willing to give up to
gain.

32. CREATIVE THINKING IS
NEGOTIATION
Understand the goals of the other person.
Determine your own goals.
Establish a range between your goals and the other
persons goals.
Identify what goals can be left unmet.
Think of alternate ways of collecting the debt.
Help clients realize that the debts must be paid and
you are willing to work with their problems.
Look at the issue from their point of view.

33. HOW DO YOU RESPOND?
If someone tells you they are short on cash, ask how
much are you short.
Persuade patients to pay with a credit card.
Get them to commit a date to pay amount owed.
Try not to go beyond 30 days.
Document and follow-up.

34. RESPONSES
If they ask “How much do I have to pay?”
Start high instead of low. Be a negotiator.
Ask for $40 instead or $5 or $10.
If they say they can’t pay $40, ask for $30.

35. PARAPHRASING
Take what the other person is saying and give
back to them.
“I don’t have money to pay.” “I understand you
said you don’t have money to pay but there is a
charge on our service.”
“I have too many bills to pay.” “I understand
about your bills but we do expect payment for our
services.”

36. WHEN THE PATIENT LEAVES
WITHOUT PAYING…
Collection is expensive!!
Avg processing cost for self payers = $8
In 3 months time, $24 on one person is spent.
Average cost of 800 bills per month
• $6,400 per month.
• 3 months time = $19,200
About 20% of what practices collect is
spent on going after receivables.

37. Once they have left the office, chances of
getting paid by self-payers could be cut in
half.
After the 60-day mark the chances drop
drastically.

38. CHANCES OF COLLECTING FROM
THE CREDIT RESEARCH BUREAU
1 – 60 days past due:90%
61 – 90 days past due:50%
91 – 180 days past due: 20% (1 in 5)

39. NO FORWARDING ADDRESS
Currently, over
$60,000 of debt is in
accounts receivables.
Update address.

40. ADDRESSING OLD
BALANCES
Patient may have and old balance but does not
want to pay because they are now 0%.
Inform patient of old balance and state that
balance should have been paid during that time
frame. It was determined that you could pay
during that time and you do owe that balance.
Start negotiations.

41. EXCUSES
Determine if it is an excuse or reality.
Eliminate the excuse so you never have to
hear it again.
Think ahead to the next excuse you might
hear and eliminate it now.
Create a sense of urgency about getting
your bill paid.

42. EXCUSE OR REALITY?
I don’t have money to pay.
Ask why they don’t have money to pay.
Make monthly payment schedule until
things pick up.
Sound as if your doing them a favor.

43. GET CLOSURE
Seal the deal.
Need a commitment for the agreement.

44. WHAT DO YOU DO WITH AN
IRATE CLIENT?
Patients sometimes get mad with you
because they owe you money and want to
get out of paying their bill.
Remember you are a professional. Stay in
control.

45. COOLING TIPS FOR THE
IRATE
Actually lower your voice and speak slowly.
Stay personal and use their name.
Don’t get angry and avoid humor.
Passing client on to colleague often changes their
tone.

46. Document
Document, Document, Document!
Always note when you have talked with a
patient regarding their account. Good
record keeping is a must because you may
need to review payment history and excuses
they have given you in the past.

47. THINGS YOU CAN DO TO MAKE
BILLS STAND OUT
Stickers on bills (Insurance obligation and
patient obligation).
Colored statements.
Yellow highlights on statements.

48. HAVE GOOD REVENUE CYCLE
MANAGEMENT
Measure performance on:
Collections
Claim submissions
Denials

49. FAIR DEBT COLLECTION
PRACTICES ACT
This act requires that debt collectors treat
you fairly and prohibits certain methods of
debt collection. Of course, the law does not
erase any legitimate debt you owe.

50. HOW MAY A DEBT COLLECTOR
CONTACT YOU?
A collector may contact you in person, by
mail, telephone, telegram, or fax. However,
a debt collector may not contact you at
inconvenient times or places, such as before
8 a.m. or after 9 p.m., unless you agree. A
debt collector also may not contact you at
work if the collector knows that your
employer disapproves of such contact.

51. CAN YOU STOP A DEBT
COLLECTOR FROM
CONTACTING YOU?
You can stop a debt collector from contacting you
by writing a letter to the collector telling them to
stop. Once the collector receives your letter, they
may not contact you again except to say there will
be no further contact or to notify you that the debt
collector intends to take some specific action.
Please note, however, that sending such a letter to
a collector does not make the debt go away if you
actually owe it. You could still be sued by the
debt collector or your original creditor.

52. MAY A DEBT COLLECTOR
CONTACT ANYONE ELSE
ABOUT YOUR DEBT?
If you have an attorney, the debt collector must
contact the attorney, rather than you. If you do
not have an attorney, a collector may contact
other people, but only to find out where you live,
what your phone number is, and where you work.
Collectors usually are prohibited from contacting
such third parties more than once. In most cases,
the collector may not tell anyone other than you
and your attorney that you owe money.

53. WHAT TYPES OF DEBT
COLLECTION PRACTICES ARE
PROHIBITED?
Harassment. Debt collectors may not harass, oppress, or
abuse you or any third parties they contact.
Use threats of violence or harm.
Publish a list of consumers who refuse to pay their debts
(except a credit bureau).
Use obscene or profane language, or repeatedly, use the
telephone to annoy someone.

54. UNFAIR PRACTICES
Collect any amount greater than your debt, unless your
state law permits such a charge.
Deposit a post-dated check prematurely.
Use deception to make you accept collect calls or pay for
telegrams.
Take or threaten to take your property unless this can be
done legally.
Contact you by postcard.

55. REMEMBER
Salary adjustments are
based on the year end
results so how well we
collect does have an
impact on ourselves
and everyone we work
with.

56. Information Sources
Collecting Accounts Receivable, presented by
National Seminars group a division of Rockhurst
University Continuing Education Center, Inc.
U. S. Department of Commerce
Credit Research Bureau
Physicians Practice March/April 2002 issue
Fair debt collection.com
Focusing on Front Desk Collections: Balancing
Effectiveness with Compassion Webcast – Health
Resources and Services Administration