With the increase in health plans requiring members to pay all or part of their office visits, practices are faced with the challenge of asking patients for full payment. This can be upsetting for the patients and uncomfortable for the staff who deal with them.

Here are eight strategies for improving collections from self-pay patients:

  1. Determine financial responsibility.If a patient has insurance, gather information on the insurer, policy number and terms, and deductibles and co-pays. This is best done at the time of the appointment. For returning patients, confirm the original information and note any updates on insurance or financial status.
  2. Preauthorize credit card payments.If a patient uses a credit card, obtain preauthorization for amounts likely to be charged to it. Be sure to use a service that not only authorizes credit cards but also verifies checks.
  3. Prepare for time-of-service collections.When an appointment is made, remind the patient that payment is expected when the service is rendered. Update the patient's payment information at the front desk at every visit and explain that full payment is due at the beginning (or end) of each visit. Train your front desk personnel to ask: "The outstanding balance on your account is 'X' dollars. Would you like to pay by cash, check or credit card?" If the patient can't pay at check-in, make sure he or she doesn't check out until an agreement is made on how the eventual payment will be handled.
  4. Update each visit.Make a copy of patients' insurance cards duringevery visit and update any new information. When your staff makes or confirms appointments, ask about insurance coverage and any changes. Some patients won't volunteer information about a change in their eligibility and your practice could provide substantial services to people who are ineligible. You might not find out until the plan refuses to pay the claim.
  5. Offer a payment plan.Some patients won't be able to pay their bill — particularly if it's large, or deductibles and co-pays are involved. In such situations, offer a payment plan that's been developed by your CPA and an attorney. The plan should state the minimum balance to qualify for the payment plan, how much the patient owes each month, and how many months he or she has to pay off the balance. Your plan might state that, unless patients qualify for hardship status through a local hospital, they must pay 5 percent of their balances or $50 a month (whichever is higher).
  6. Set up prompt-pay discounts.Uninsured, self-pay patients will likely have difficulties paying the bill. Instead of turning them away, offer a discount for payment within certain time periods. For example, they might receive a 15 percent discount for payment on the day of the visit, 10 percent within 10 days, or 5 percent within 30 days — as long as they pay the full bill amount.
  7. Use electronic billing and payment.When possible, send bills via e-mail and allow patients to check account balances and make credit card or PayPal payments via your website. Also accept a variety of payment types, such as credit cards, check cards and eCheck / automated clearing house payments. The more flexible the payment options are, the more likely a patient will pay. But make sure you follow health care billing compliance requirements and patient data protection standards.
  8. Train office staff.It's not easy to discuss financial accountability with a patient. Show your staff how to interact with patients about payment issues and assign experienced billing staff to address serious patient payment conflicts at the front desk.

Taking the above steps takes time and effort but inadequate processes create problems with delayed payments and bad debts — and that hurts your cash flow and the bottom line.