6 steps to handling patient complaints effectively

1. Change Up The Way Your Office Handles Patient Statements, Follow The Socrates Method (6 Steps explained) RCM Tip Of The Week “THE SECRET OF CHANGE IS TO FOCUS ALL OF YOUR ENERGY, NOT ON FIGHTING THE OLD, BUT ON BUILDING THE NEW – SOCRATES” Socrates, one of the greatest thinkers of the age, was surely not thinking about Revenue Cycle Management when he wrote this, however, it surely can apply! When you think about this phrase in terms of Revenue Cycle Management, we can say that there are many things that have been done the same way in many practices for many years, for the shear reason of, “we have always done it this way”. There are lessons to be learned when you decide to clean up the old and focus on the new – one aspect of RCM, is Patient Statements, Often overlooked and underworked properly. I worked with a practice that had a statement problem, to the tune of about 500 statements we inherited when they signed up for our services. As the Account Manager for this practice, I took a look at the statement process and

2. discovered that out of the 500, about a fourth of them, were repeatedly being sent out since 2014/2015 for “No Show” fees of $25.00 a piece. I then discovered that there were another fourth that were also for 2014/2015, due to balances equal to $5.00 or less. The next batch were comprised of about another 50 statements that had Credit Balances on them and also had not been worked since 2014/2015. Second to last, were about 90 statements that had actual balances due, but had never been collected, also from 2014/2016 and then finally the rest were 2016 (at that time the current year). The total reflected by all these patient statements was a whopping $75000.00 uncollected as it initially appeared. I took out the “old” balances that were from the No Shows/$5.00 and under balances and that removed about $20,000.00 right off the top and reduced the number of statements going out twice a month by 200, so I was down to 300 statements to figure out. I then tackled the Credit Balances, which dropped the “old” down to 210 statements to work with and took another $15,000.00 off the top. Then it was time to hit actual balances from 2014-2016. The first “New” process I put in place was to review all payments from Insurance and Patients on all of these remaining statement balances, to weed out incorrectly posted payments. After that process of elimination of the “Old”, I was down to 100 viable and collectible patient statements, which equaled to a true balance due of $30,000.00. I put the following “new” processes in place: (6 steps explained)

3. 1. Run statements bi-weekly 2. Go through them and vet out credit balances, low balances ($5 and under), zero balances – put them on a warning/flag status on the patient account that says balance due prior to next visit – instead of sending 20 statements (costly to practice to keep doing when they don’t get paid) 3. Verify insurance and patient payments on all other statements to ensure that payments have all been posted correctly (do this for credit balances as well) 4. For credit balances, verify who is owed the refund, patient or payer and refund accordingly 5. For actual, true balances due, after all has been verified, send out to the patients no more than three times and with three calls for follow up. 6. If the patient does not pay the balance after three calls and three statements, then you can opt to put them in collections with an outside agency, as you can generally recoup about 15-30% of what is owed or you can also put a warning note on that patients account that they must pay their balance due prior to any future services at the office. So the moral of this story is the following: Implement new processes out of the old and learn from what doesn’t work to keep the wheel of progress going forward in your practice – Read More: https://www.billingparadise.com/blog/handling-patient-statements-socrates- method/?utm_source=blogpdf 888-571-9069 info@billingparadise.com