Year End Collections

Year End Financial Clean Up Ideas

The end of the year is approaching and it’s a great time to take a hard look at your accounts receivable, particularly patient balances. Now is the time to review ways to start the New Year with as few problem cases as possible. Pay extra attention to working on outstanding balances, whether to collect them or write them off as bad debts. The following are a collection of tried and true ideas that can assist you with your own “out with the old” and “in with the new” approach. Thanks to our many clients and customers who have contributed to these ideas.

1. Simply Ask for Payment

If you have not been diligent in cleaning up overdue patient accounts throughout the year, use November and December to make personal calls to anyone with a balance due. This can be done over the phone, but can also be done face-to-face, as these patients walk in for appointments. Run your accounts receivable list or outstanding patient balance list, and compare it to your daily schedule. Note any patients coming in that day with whom you should have a conversation.

• When on the phone, be prepared to collect credit card information and send a receipt later. It’s far better than waiting for a check.
• When dealing with a patient face-to-face, get them to commit to paying something, even $10 toward the balance immediately, even if they must get back to you on a payment plan.
• Don’t be afraid to say, “I am working toward a personal goal of making sure all accounts are in good order before the New Year. I know you want this balance off your plate before the holidays get you busy and the New Year arrives””.
• When taking a credit card for a partial payment, get permission for that monthly amount to be paid as a monthly auto-debit until the balance is zero. The scripting could go like this: “Thank you, Mrs. Jones, for this payment. With your permission, I’m going to set this up to charge this same card this amount each month until your balance is zero. How does that sound? This way, you won’t have to worry about it, and we’re happy to accept these payments toward your balance due.”  If the patient says that the amount is more than he/she can afford monthly, use this opportunity to ask what amount they can afford to put on the card. We like using an auto debit program like Cash Practice Systems, to compliantly automate those payments.

2. Offer a Year-End Amnesty Program

If you hit a dead end while attempting collections, writing off a portion of the debt can be a compliant, collection strategy. Your compliance policy must outline these intentions and your procedure should follow accordingly. Randomly writing off balances, without proper policy, is dangerous. Use a script or letter that says something like this:

“In the spirit of the holiday season and in preparation for the new year, Dr. Brown is offering this one-time amnesty program. Pay your balance in full by December 31 and take ____% off. Take advantage of this immediately as we will not be able to offer this in the New Year. Hurry before the boss changes her mind!”

This can also be included on a monthly statement.

3. Use Balance Forgiveness… Sparingly

For those accounts which have small, or sometimes called “”chicken feed”” balances or those that the doctor wishes to write off due to other circumstances, never do so without sending a note to let the patient know what’s happening. The note should be a personal note from the doctor or office manager. It can be as simple as:

“Mrs. Jones: I understand that there may be many reasons why you have not been in touch with us regarding your overdue balance. I believe that if you could have paid this small balance, you would have. I’m aware of circumstances that may have prevented you from paying in full. In the spirit of the season, I’m writing off your balance of _____. Considering your extenuating circumstances, I want to do this for you so that you can have a clean slate for 202X. Please know that you are welcome here and I hope you consider this office when you have additional chiropractic treatment needs.”

General Rules of Thumb

1. Know your state and federal laws regarding the collection of bad debts. In the context of those laws, remember that Medicare patients should be treated the same as other patients with outstanding debts. Writing off balances after all collection efforts have failed is not a compliance issue, assuming you have collection policy included as a part of your required Practice Compliance Program.
2. Make sure you verify all insurance again at the beginning of every year. Copayments, deductibles and other factors change often. Many people, including Medicare patients, use end of year Open Enrollment opportunities to change carriers. This is especially true of Medicare patients changing from traditional Part B insurance, to Medicare Part C, or Medicare Advantage Plans. This could mean that the patient is no longer covered in your office if you do not participate with that carrier. Be alert as you ask for new cards! And remember: January 1, 2020 is the deadline for using the new Medicare Beneficiary Identifier (MBI). Claims submitted with the old ID number will be denied.
3. Never write off a “chicken feed” balance without sending a note that you are doing so. Not only is this good PR, it helps the patient to know they have a clear path to your office. And good communication always wins the day!

Nobody likes to deal with unpaid balances… this includes both the patient and the office. Commit to using one of these strategies to start 2020 on a stronger footing with cleaner A/R, and the confidence to enter this new decade with an improved collection’s approach.

This training is offered as a service to the profession from KMC University, THE Chiropractic Reimbursement and Compliance Experts. 

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