QUESTION:  Are there strategies and approaches you can recommend for speaking to patients about past due accounts?

 

ANSWER:  The best approach is always the honest and direct approach.  Look for a reasonable solution and remember that it never helps to make the patient wrong or to imply any willful neglect when first broaching the topic.  Here are some ideas to consider:

 

1        The first step should always be a reminder.  It might make sense to send an invoice through the mail if you have not already done so.  Marking this mailed bill as a "REMINDER" is a gentle way of bringing the matter to the patient's attention.

2        If you wish to speak in person with the patient, you can do so on their next visit, after you deliver any needed care, or you may want to do so by telephone outside the clinic setting.

3        If a gentle reminder does not work, the next step can be to inquire if there are difficulties.  If there are genuine financial hardships, work out an affordable payment plan that meets the patient's circumstances but also the needs of your practice. 

4        If there are insurance issues or limitations, it is important that you and/or your staff be aggressive advocates for the patient with the carrier.

5        Take responsible and positive steps to inform and educate the patient on what the limitations of their insurance coverage are, letting them know at the earliest appropriate moment that they may have to assume some portion of the financial obligation for their chiropractic care.

6        Always maintain your dignity and professionalism in all communications with patients, spoken or written, regarding billing. 

7        Act early so that balances do not become so large as to be overwhelming to the patient.

8        Always make sure that patients who are behind on their bills do not have any issue with the nature or quality of your care or the operations of your clinic.  Get any issues they may have out in the open as soon as possible.

9        If gentle measures are ineffective, strengthen the message, and remind the patient of the agreement into which they entered and the obligation they have incurred.

10    It is always best to have a staff member address the next level of communication to the patient, preserving to the greatest degree possible your role as the doctor and caregiver.

11    You have a right to terminate care pending a resolution of outstanding balances.  You must, however, carefully consider the urgency of the need for care, whether the patient has other options for care and be certain that you have taken all reasonable steps to resolve the matter first.

12    Legal efforts or collection agencies should be your last resort, and only when balances are large and you believe that the patient is willfully seeking to avoid their rightful responsibilities. Always know the collection laws.  Remember, you live in an environment where your collection efforts can have spillover effects to your other patients and the community.  Always proceed with caution and good advice from professionals at this stage of the matter.

 

 

The International Chiropractors Association is the oldest continuously existing international chiropractic organization in the world. The ICA represents thousands of practitioners, educators, students and lay persons, and ICA has traditionally been and continues to represent the moderate voice of the chiropractic profession.  The ICA supports and promotes the interests of chiropractic, chiropractors and the patients they serve through advocacy, research, and education. Throughout its long history, the International Chiropractors Association has sought to educate and inform the public, other health care professions and health policy makers on the principles and definitions of chiropractic to foster a broader understanding and acceptance of the profession. The ICA has also established standards of ethical, technical and professional excellence for chiropractic education and practice.
 
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