A Review of “5 Best Practices for Collecting Patient Payments” by Advanced Data Systems
By Kevin Howard
Patient billing—and collecting patient payments—is critical to business success, yet is an area of business where
many private practice owners struggle.
Whether it’s front-end office staff not collecting copayments at the time of service, or back-end office staff getting
bogged down in paperwork and missing out on billing charges, it’s in practice owners’ best interest to resolve their
payment collection issues swiftly. The video “5 Best Practices for Collecting Patient Payments” by Advanced Data Systems
outlines steps for new and established business owners who are struggling to gather those all-important patient
THE OLD AND NEW REIMBURSEMENT MODEL
The speaker in this recorded session, Ben Buchanan, the director of TSYS, a payment solution, says that the old model of
collecting money is slowly disappearing. This old model of health reimbursement largely depended on governmental payers
like Medicare, Medicaid, and private insurers such as Blue Cross Blue Shield, Aetna, Cigna and so on. Patients were
largely out of the picture unless they had to pay a copay or pay off a deductible.
For a private practice, that meant that the old model was a relatively steady stream of income. This transaction model
was more business-to-business, where, for example, an insurer pays a private practice for the majority of services that
were rendered and the majority of the money for the services that were rendered went directly to a practice. That
transaction allowed private practices to more easily forecast their budgets because practices could count on where the
money was coming from.
The new reimbursement model, according to Buchanan, will increasingly shift to the backs of patients or consumers. He
cited the United States government’s goal to transition from fee-for-service to value-based reimbursement for 75% of
reimbursement to providers by 2020. This reimbursement shift makes private practice employees a more critical part of
providing a great customer experience for patients since those value-based reimbursements are tied to the overall
patient experience within the practice, beyond just the medical intervention that the patient receives. Add to that the
prevalence of high-deductible insurance plans, many with deductibles upwards of $10,000, patients now are saddled with
the majority of their payment.
EDUCATING STAFF ON HOW TO DISCUSS PAYMENTS WITH PATIENTS
It’s time to train all staff, the front desk, the back office, therapists, leadership, and everyone in every role on how
to provide excellent service to patients and the policies and procedures that lead to patient payment. The whole of a
private practice must buy into the goals of the practice and understand these trends.
The emotions that take place at the checkout desk can run the gamut of excitement, fear, doubt, happiness, and
everything in between. Buchanan says that when a patient is handing a staff member a credit card or a check to pay for
services, the emotions running through their mind are tied to the conversation they just had with the practitioner back
in the exam room. So, every conversation that takes place needs to be handled with professionalism, courtesy, and
It is important for practices to think about who’s having billing and payment discussions with patients and make sure
they’re comfortable having potentially difficult conversations. This staff should be knowledgeable about the practice’s
services, billing, and policies; be able to articulate why a bill is priced the way its priced; have the ability to
disarm a potentially combative patient, and get patients to agree to payment of services.
ACCEPTING MULTIPLE FORMS OF PAYMENT
According to Buchanan, 70% of all US consumers use three different types of methods to pay bills. Private practices need
to offer different mediums and tools to be able to accept payments when and where the patient wants to pay.
This may include having a kiosk solution at the front desk in addition to having a credit card machine or terminal. It
can mean sending statements in the mail—though potentially not the most efficient process, this is still a very
lucrative and beneficial tactic delivered within the practice setting—leveraging secure email and E-statements, and
taking online payments or through your patient portal. Online solutions available via your website or patient portal are
ideal not only for the patients’ 24/7 convenience, but also for the practice as they don’t require staff to operate it.
PREPARING FOR THE FUTURE
Seeing that the reimbursement model is changing, practice owners should train their employees to explain bills and
collection options with professionalism and empathy. Providing a positive experience that extends beyond treatment to
include front-office staff interactions as well as billing and payment processing, ensures that, as reimbursement is
increasingly tied to overall patient satisfaction, your practice is doing all it can to ensure that payments are
collected. Private practices that look ahead at where payment trends are headed will be best prepared for the next phase
of the patient collection and reimbursement evolution.
Kevin Howard is a staff writer for PPS based in Mount Laurel, New Jersey. He may be reached at firstname.lastname@example.org.