Idea Transcript
PractEssentials Practice Operations > Collections Collections: Advocacy and Policy for Health Care Advocacy Approach and Written Policy Are Key Elements in Sound Collection Strategy Submitted by: Thomas A. Stenklyft, I.C. System, Inc. Physicians face a serious challenge in staffing their collection function. Typically, debt collection is a part-time responsibility. Thus, many collectors are full-time employees wearing two hats. Under one hat is a debt collector. Under the other is a care-oriented patient advocate. Can the same person wear both hats? Yes! Care-oriented patient advocates can be good debt collectors. They can handle difficult people without caving in, and can be strong without becoming antagonistic. Two conditions are required. First, the collector must understand how to take advantage of the power of advocacy. Second, the office must have a written collection policy that is enforced. The Antagonist Approach Is Wrong for Health Care Providers The person who acts as antagonist takes on what most people think of as the traditional posture of the collector: "pay or else." It is essentially a threat with the collector as the person of strength forcing the debtor to pay up or suffer the consequences. This is poor strategy for the health care provider for at least three reasons: First, threats harden the resolve of debtors against payment. Even if debtors pay, the fact they were forced wears poorly, and collectors can become targets of any hard feelings or resentment. Thus, payments obtained under threat are short term gains paid for over the long term in continuing ill will. Second, health care providers don't want image problems. A tough guy image does nothing to forward the growth and development prospects of the practice. Third, the type of people attracted to work in health care offices are among the least frightening people on the face of the earth. They fall so far out of character when they try to act as antagonists, that they lose all credibility in the eyes of the debtor.
The Advocate Approach Collects Money Professionally The collector as advocate claims no power to hurt debtors. On the contrary, advocates make it their business to make debtors aware of existing conditions or events already in motion that are hazardous. Advocates neither create hazards nor start dangerous events in motion. They do, however, have the power to stop them. By analogy, advocates collect much like observers who watch a river flow by and pass along navigational information to boaters. The advocate observer points out sand bars, floating logs, and partially submerged rocks. The advocate observer put none of those obstructions into the water. The advocate observer has no interest in seeing anyone drown, so brings known hazards to the attention of boaters. Boaters make their own navigational decisions and either avoid the obstructions or risk suffering the consequences. Advocates Need a Written Debt Collection Policy Central to the ability of a collector to act as advocate, is to have a written debt collection policy in place. The goal of such a policy is to insure fairness to all patients served by the practice, including those who pay promptly. A debt collection policy is generally short and must include four key elements: 1. 2. 3. 4.
A statement of the practice attitude toward collections. Identify who at the practice deals with debtors, and include the collector in any negotiations leading to the making of exceptions. List the techniques the practice uses internally to deal with debtors. State the boundaries showing how far the practice will go to enforce collections.
The first two elements clarify the role collectors play, and what is expected of them. The attitude of the doctor, or the relationship of attitudes in multiple doctor practices, tells collectors what level of support they can expect from the boss. When negotiating with debtors, collectors need to know what arrangements (if any) can be made, and how exceptions are considered and decided. Doctors who make unilateral decisions as an expedient way of avoiding the subject ("Don't worry about the bill.") are actually increasing the number of patients who will come to them with billing problems. Unilateral exceptions also undercut the authority of the staff, further increasing doctor involvement in billing questions. The second two elements enable collectors to act effectively in the role of advocate. Based on what the policy requires, events are automatically put into motion in response to nonpayment. Advocate collectors simply make sure the debtor knows what events are scheduled to happen according to the practice policy, and what the debtor needs to do within a time frame to keep that schedule from running its course. For example, if it is time to turn an account over to your collection agency or attorney, antagonists would threaten the debtor with that fact. Advocates, instead, would approach the situation by saying, "Mr. X, our policy requires that overdue accounts be turned over to (name collection agency) by the 30th of this month. That takes matters out of our hands. We don't want that to happen, and we're sure you don't, either. Will your $300 payment arrive in our office before the 30th" The same approach would be used to inform the debtor other actions including interest being added after a certain date, cash required at time of service for future non-emergency care, the doctor withdrawing from providing further professional non-emergency services, reporting debt to credit reporting agencies, litigation, attachment or garnishment following litigation, etc. A written debt collection policy is an advocate's best friend. The policy, not the collector, is what causes things to happen. A written policy is an attempt to see that all are treated fairly and equally. It enables collectors to effectively play the role of advocate while insulating them from the debtor's wrath. An advocate can professionally attempt to collect from anyone, whether they are a stranger, a friend, a relative, or a business associate. As an advocate, the collector's appeals are based on a foundation of fairness that only a written collections policy can provide. Doctors can avoid the extremes in dealing with past due accounts. The choice need not be made between caving in or going for the throat. There is a middle road to follow for those who want to maintain their professionalism while attempting to recover money that is rightfully theirs. That middle road can be traveled by a care-oriented patient advocate collector, who is supported by a written debt collection policy.
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