Speaker advises orthopedic practices about managing accounts receivable
Front desk preparation, benefits verification, chart review and payment prior to the appointment are crucial steps in managing accounts receivable, according to a speaker at an American Alliance of Orthopaedic Executives webinar.
“We pay a lot of attention to what we do before the appointment,” Shannyn Tinberg, CPC, billing manager at Midwest Orthopaedics PA, said in her presentation on managing accounts receivable. “As it has been said many times, the incentive for the patient to pay is higher before the visit than after the visit. Once they feel good, they sometimes forget they have a bill.”
Implementing proactive strategies for everyone on staff is an important part of the process and one reason Midwest Orthopaedics was identified as a top performer in accounts receivable, Tinberg said Chart review and payment estimation are two strategies to ensure successful accounts receivable, she said.
“Our staff will get their encounter forms, look to make sure the insurance is active [and] that we have all pertinent information marked on that form. If they have a carrier that does not cover durable medical equipment (DME), then we know not to give that to them in our office. We will give them a script and send them out. That way we do not lose money on giving them a piece of DME that we will not get paid for,” she said. “We also know when a patient is scheduled for surgery. So, we work up that estimate, and we provide that in writing to the patient. We answer any questions, and we set up a due date for the payment.”
Barbara Sack, MHSA, CMPE, executive director of Midwest Orthopaedics, cautioned practices that while chart reading is helpful, it is not “magic.”
“We have had to remind staff who are doing the chart pre-reading and so forth that although it does tell you whether or not that patient has that insurance, whether that insurance is active, it does not tell you whether we are active in that network,” she said. “You do have to still pay attention to whether that is an insurance we participate in, and so it is not completely magic.”
Tinberg said Midwest Orthopedics requires 50% payment prior to surgery.
“If it is $1,000 or more, we will ask for half of it. If it is a smaller amount, if they are going to owe $200 to $300, we will ask for that in full. The more we can collect before surgery, the better we are, and the patient will not be saddled with as many expenses afterward,” she said.
“There has not been any negative patient feedback,” Sack said when asked about feedback on the prior payment process. “We get a lot of feedback from patients on a lot of things. The prior approval process is not one of them. Some have strong feelings one way or another about the kiosk, but the application itself is invisible to them,” she said.
“There are a lot of people – who usually are older – they will tell us that they have never had to prepay before, and they are a little insulted that we ask for money before their service. We just have to gently explain that this does a number of things: It helps cut down on the billing that we have to pay for, the expenses that we have, and it lets them know and plan for what their expense is going to be,” Tinberg added. “Some patients, they do not have the money or they just do not care for that policy, and they might cancel their surgery; but for the most part, most of our patients do understand it, and they will pay, and we will just move forward,” she said.
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Tinberg S, et al. Presented at: American Alliance of Orthopaedic Executives webinar: Secrets from top performing practices. July 16, 2020.
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