e-MDs Billing: Patient Collections, How To Collect Once Insurance Has Paid

It’s a tricky business. Most of the practices that bring us on board don’t have a formalized process. There are two pieces to the puzzle. The first is collecting from the patient on the date of service. We have a three part series on best practices for this phase here. The other area where practices tend to have gaps in the process is once insurance has paid. We’ll take a high level look at how to tackle this issue today.

#1 Create a Worklist in the Collections Module

Log into Bill. Find the “Collections” button with the hammer icon.

Create a new Worklist using the filters described in this PDF:

Once you click save you are now able to see what is owed from each guarantor and work those claims efficiently.

The main goal here is to check each balance to make sure the patient owes what you are billing them for. If they don’t, you’re potentially committing insurance fraud. Once you’ve completed this process (and it could take quite a bit of time if it hasn’t been done before or recently), move on to step 2

#2 Send Statements to Patients

Smaller practices will often print these directly from e-MDs. (Fill out the contact form below if you need help with this process)

Other practices upload their statement files to their clearinghouse. The clearinghouse then prints, folds, and mails the statements for you on nice statement format with the practice’s name at the top. Neat!

Again, this process should be done only once you’ve determined the correct amount that the patient owes.

#3 Determine Your Follow Up Process

Every practice is unique in terms of how they want to proceed once they have sent out the first statement and a set period of time (most practice use 30 days) has passed without payment or contact. Here are the most popular ones we see:

Send second statement and a separate letter sternly requesting payment with potential to send patient to collections agency and resign from care. You can build your letters inside notice processor.
Send another statement and a separate letter politely requesting payment (put statement hold on)
Send a second statement

#4 Execute Your Process

Follow up using the process you selected. Document your actions in the “visit notes’ portion of the invoice for each action taken.

#5 Rinse and Repeat!

At this point, if you haven’t heard from your patient regarding their balance during your next pre-defined time period, it’s time to step things up a bit. Here’s a probable next course of action for each of the scenarios from step #3:

Gather balances and contact your preferred collections agency to start the 3^rd party collections process. Send letter resigning from care with 30 days emergency care provided.
Send a second letter sternly requesting payment with potential to send patient to collections agency
Place account on a statement hold, send friendly letter politely requesting payment.

Again, you’ll want to document each step taken along the way in the invoice notes section of the invoices in question. Keep in mind that each month, you start back with step 1 to capture any new outstanding patient balances. Take that set of new balances and follow them through the process as well.

This is a high-level view of the sample processes that most of our practices use. There is obviously a great deal of details that we’ve left out of this article. For more information, or training in these areas, please fill out our contact form below. Thanks for reading and continued success!!

It’s our pleasure to provide these e-MDs tips and tricks to you. As always, let us know if we can be of assistance to your practice by filling out the contact form below.

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Solor is a specialized third party medical billing company for e-MDs® Practices. e-MDs® is a registered trademark of e-MDs Inc. e-MDs Inc. is not affiliated with Solor, Inc., our products, services, or website. Additional legal disclaimer here: http://wp.me/P7cvJE-kI