Home > Financial Matters, Tips > Co-Pay Collection Best Practices @ TransforMED – Transforming Medical Practices

Co-Pay Collection Best Practices @ TransforMED – Transforming Medical Practices


Co-pay Collection Best Practices

By Rhondda Francis and Sarah Breshears

primary practice co-pay colection at the check-in window

How many patients left your office today without paying their co-pays? Three? Five? Eight? Do you even know? Improved co-pay collection starts with practice leadership setting the expectation and is remedied by taking just a few concrete steps to set policies and procedures, train and educate staff, and educate and inform patients.

Just a few years ago, co-pays were $5. Today, $30 co-pays are the norm. Health care coverage is trending toward larger co-pays and patients are shouldering a larger percentage of health care costs, including purchasing high deductible health care plans where the patient is responsible for 100% of the cost of non-preventive care up to the deductible limit.

TransforMED Practice Enhancement Facilitator, Jim Arend says, "Consider this assumption, if the average co-pay is $20 and each provider has 25 patients per day that is $500 of co-payments per day.  Further, if there are 200+ workdays in the year, co-pays account for over $100,000 for each provider.  This is a significant amount of revenue."  

Arend says he believes co-pay collection habits among the TransforMED National Demonstration Project practices at the outset of the pilot improvement project were "sporadic", adding diplomatically "Some did well – others not." But TransforMED has been effective in helping practices get their co-pays collected consistently. "Often times," says Arend, "it was a simple matter of no one monitoring the collections."

Establish Co-pay Collection Policies and Procedures

The best time to collect co-pays is when patients are in your office. Once they leave your office, collections become more expensive and more difficult. In fact, with forms, envelopes, stamps, and the time spent – not to mention re-billing – the cost of collecting a co-pay after the fact can be nearly as much as the amount of the co-pay itself!

Develop a written policy – to be shared with your staff – that collection of co-pays is required before the patient’s appointment. Some practices prefer to handle co-pay collection as part of the checkout process, but TransforMED recommends co-pays be collected in advance of the encounter. This written policy helps ensure that all staff members and patients are aware of expectations and know and understand the policy. Make the policy available to patients on the practice website and make sure it’s communicated in person to new patients.  Get signatures from new patients acknowledging that they accept financial responsibility for services.

Arend cautions that getting a handle on your co-pays is more than words on paper. In addition to policies, you need accounting controls. "Co-pays need to be controlled carefully.  This is especially true because they may be paid in cash." He recommends three basic policies and procedures to control co-pay cash (see sidebar) and also advises practice leaders to seek guidance from their accountant.


Read the Full Article : Co-Pay Collection Best Practices @ TransforMED – Transforming Medical Practices

Categories: Financial Matters, Tips
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