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Foundations of the Billing and Collections Process

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How to Have “The Talk”

Every parent knows (and dreads) when it’s time to have “the talk” with their kids. Some of us do a better job than others—and the same is true for those of us tasked with having “the talk” with our new patients. In fact, for some of us, discussing the birds and the bees can seem like a walk in the park compared to actually having to talk to new patients about—gulp—money.

Money scares a lot of people and makes them incredibly uncomfortable. When the office staff are the ones who are frightened and twitchy on the subject, it communicates itself readily to patients. So, the first order of business is to get totally clear on the practice’s financial policies, fee schedule, and third-party payer coverage. When we know what the heck we’re talking about, we’re able to speak with more confidence and compassion.

Patients don’t want to talk about money, either

Mostly, that’s because they don’t know how much they’re going to owe, and they’re worried they’re going to get conned somehow—and their imagination often comes up with a worst-case scenario. So our first intention should be to minimize the unknown for our patients because a frightened patient will not only tend to be non-compliant with therapy, they also are given to suddenly dropping off the radar screen when it comes to payment—and sometimes leaving the practice altogether.

Begin this conversation during that first phone call to the office. Why? Because it’s critical that new patients know what to expect when they come in for their first visit. It’s also a good idea to avoid having a difficult conversation about finances with a patient who just might, at the top of their lungs in a crowded reception room, try to embarrass you out of collecting from them that day.

Couple Therapy

You want them to know that you’re comfortable talking about your fees and your financial policy. You want them to know that you expect them to pay something on their first visit. It is a courtesy to give them an idea of what to bring, or what forms of payment you accept, so they can have an easy transaction at the front desk at the end of their first visit.

Most patients will appreciate your candor because the unknown dollar amount in their head may be much scarier than the actual dollar amount they will owe. Since you brought up the fees and what you expect them to be prepared to pay, you’ve opened the door for them to express financial concerns right there on the phone and get any sticking points resolved.

Let them know you have a pre-acceptance interview process between patient and doctor—you do, don’t you? —with no financial obligation. This “conversation” about chiropractic and their condition allows them to get to know the doctor and determine appropriate next steps. You can address financial hardship, other financial concerns, and the fact that you don’t turn patients away based on their ability to pay for care. Your goal is to get the patient to schedule. Studies show that patients who actually come to your office are far more likely to return to your office rather than seek care elsewhere. So, getting them on the calendar is an important part of your practice success.

When scheduling, on that initial phone call, your conversation might start with something like this:

“Now, I’m going to ask you some questions that will save you time when you are in the office. Do you have some kind of insurance that you’d like our assistance with filing for you?”

If they say yes, ask them to get their insurance/Medicare card/accident information, etc., and review it with them over the phone. Once you’ve gathered all the data, offer them their choice of two different appointment times, and get them on the schedule. Verify that they know how to find you, or that you will send directions to your clinic, and how they will receive new patient paperwork to complete and bring to their first appointment.

If they say no to third-party coverage, an affordable alternative for cash-paying patients is for your practice to join a Discount Medical Plan Organization (DMPO). We recommend ChiroHealthUSA, which costs the patient and their family just $49 a year and allows you to simply and  correctly offer legal discounts.

Patients feel relieved

Patients are excited to hear, “Not to worry… Dr. Smith is a member of a Discount Medical Plan that allows us to extend discounts to our patients without third-party coverage”

Keep the conclusion short, sweet, and crystal clear: “We’re excited to see you on Wednesday at 10 a.m., Mrs. Jones. We ask you to come prepared to pay (for example) $99.00 towards your deductible and co-pay.” Forewarned is forearmed!

How’s your New Patient phone call process?

Does it need a shot in the arm? Check out our affordable Discovery Consultation to have a private consultation with one of our certified specialists to discuss your process. Ask if you qualify for one of our preferred partner discounts.


Kathy Mills Chang is a Certified Medical Compliance Specialist (MCS-P), Certified Chiropractic Professional Coder (CCPC), and Certified Clinical Chiropractic Assistant (CCCA). Since 1983, she has been providing chiropractors with reimbursement and compliance training, advice, and tools to improve the financial performance of their practices. Kathy leads the team of KMC University specialists and is known as one of our profession’s foremost experts on Medicare, documentation and CA development. Kathy or any of her team members can be reached at (855) 832-6562 or info@KMCUniversity.com

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By Kathy Weidner

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