The best way to improve the patient payment component of the revenue cycle is to collect cash payment in advance for healthcare services. However, without solid processes and disciplined implementation, upfront cash collection can challenge and frustrate front office staff, often contributing to accumulation of outstanding patient debt. Insurance companies sending payments directly to patients instead of the office further exacerbate the difficulties of debt collection.

A typical debt-processing scenario proceeds in three phases, starting with billing, to debt accumulation, to selection of the most appropriate collections method. Clear definition of responsibilities along with payment arrangements help effective collections, minimize practice risks, and reduce administration costs.

Billing Phase: Your billing office sends patient invoices and a number of reminder invoices regarding outstanding balance directly to the patient.

Debt Accumulation Phase: The patient does not pay the invoice for a time period exceeding desired limit (typically, 90-120 days). Accounts receivable distribution over the span of 30, 60, 90, and 120 days takes the shape of inverted horizontal S.

Debt Collections Phase: The practice must consider at least four alternatives for outstanding debt collection:

1. Dismiss the patient until all debt is paid.
2. Offer the patient the opportunity for a financial hardship write-off.
3. Take the patient to small claims court.
4. Hire debt collections agency.

First, dismissing a patient is not always an appropriate option because of associated reputation implications and potential medical malpractice risk. More importantly, dismissing the patient only stops subsequent debt accumulation but does not eliminate the already accumulated debt.

Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

1. Specialized Industry Expertise
   • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
   • "Skip-tracing." Ability to find patients that changed addresses or names
   • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
   • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
   • Understanding of Billing Processes Knowledge of healthcare claims processes and ability to successfully negotiate with insurance companies

2. Proven Performance
   • References. Provide a list of specialty-relevant references.
   • Quantitative Performance Measurement. Compare collections performance including percent collected and time to account liquidation.
   • Client satisfaction. Demonstrate long client retention history.

3. Centralized Control
   • Transparency. Provide real time status on all collection activities, including amount collected, actions taken, and patient responses. Include a wide selection of reports available over a secure Internet connection 24 x7.
   • Tight Cash Flow Control. All collected money goes directly to your practice or bank account, increasing positive cash flow and immediately collecting interest. No waiting for a collection agency to take its percentage first and pay you at its convenience.
   • Lower Risk with Indemnification. Collections agency must indemnify your practice from lawsuits resulting from collection efforts through a written hold-harmless agreement.
   • Flexible Contact Style. Avoid offending your patients. Collections agency must be able to vary its patient contact style (e.g., diplomatic or intensive) on a patient-by-patient basis according to your specific direction.
   • Patient Relationship Maintenance. Collections agency must not intrude on your relationship with your patient. If you choose so, you should be able to maintain continuous control of patient's account, including negotiation of payment plans or dispute resolution directly with your patient as a key element of the collection process.

4. Economies of Scale and Fees
   • Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
   • Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency must continue to pursue payment of all debts through any and all legal means available, including wage garnishment, bank account seizures, or, in rare cases, arrest. Success fees vary from 30% to 50% of recovered debt.
   • Even Focus Regardless of Balance Size. Collections solution must be effective for all balances regardless of amount owed.

5. Interaction between Bill
   An Introduction to Podcasting and How You Can Use It In Your Small Business
   According to Wikipedia,"A podcast is a multimedia file that is distributed by subscription (paid or unpaid) over the Internet using syndication feeds, for playback on mobile devices and personal computers. Like 'radio', it can mean both the content and the method of broadcast. The latter may also be termed "podcasting". The host or author of a podcast is often called a podcaster."And you thought blogs and blogging were a mouthful! Let me try to say the same thing with some English thrown in for good measure:A podcast is a multimedia file (for example, mp3 or video) that is distributed by subscription (you can sign up through an RSS feed, iTunes, or directly from someone's website) over the Internet using syndication feeds (RSS and Atom are the most popular), for playback on mobile devices (CD players, mp3 players and iPods*) and personal computers.* For those who are thoroughly confused about what mp3 players and iPods are, here is a very quick explanation:They
   on Phase: The patient does not pay the invoice for a time period exceeding desired limit (typically, 90-120 days). Accounts receivable distribution over the span of 30, 60, 90, and 120 days takes the shape of inverted horizontal S.

   Debt Collections Phase: The practice must consider at least four alternatives for outstanding debt collection:

   1. Dismiss the patient until all debt is paid.
   2. Offer the patient the opportunity for a financial hardship write-off.
   3. Take the patient to small claims court.
   4. Hire debt collections agency.

   First, dismissing a patient is not always an appropriate option because of associated reputation implications and potential medical malpractice risk. More importantly, dismissing the patient only stops subsequent debt accumulation but does not eliminate the already accumulated debt.

   Next, financial hardship write-off may not be feasible as some patients refuse or are ineligible for it.

   Third, a small court can help collections only from patients with steady work and debt under $5,000, upon paying a typical $75 processing fee. Keep in mind that a small court limits its scope to liens and/or wage garnishments instead of actually making collections.

   Finally, a specialized collection agency with thorough understanding of the claim payment process and result-oriented and accountable approach to customer service recovers on average 15% of outstanding debt.

   Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

   1. Specialized Industry Expertise
      • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
      • "Skip-tracing." Ability to find patients that changed addresses or names
      • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
      • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
      • Understanding of Billing Processes Knowledge of healthcare claims processes and ability to successfully negotiate with insurance companies

   2. Proven Performance
      • References. Provide a list of specialty-relevant references.
      • Quantitative Performance Measurement. Compare collections performance including percent collected and time to account liquidation.
      • Client satisfaction. Demonstrate long client retention history.

   3. Centralized Control
      • Transparency. Provide real time status on all collection activities, including amount collected, actions taken, and patient responses. Include a wide selection of reports available over a secure Internet connection 24 x7.
      • Tight Cash Flow Control. All collected money goes directly to your practice or bank account, increasing positive cash flow and immediately collecting interest. No waiting for a collection agency to take its percentage first and pay you at its convenience.
      • Lower Risk with Indemnification. Collections agency must indemnify your practice from lawsuits resulting from collection efforts through a written hold-harmless agreement.
      • Flexible Contact Style. Avoid offending your patients. Collections agency must be able to vary its patient contact style (e.g., diplomatic or intensive) on a patient-by-patient basis according to your specific direction.
      • Patient Relationship Maintenance. Collections agency must not intrude on your relationship with your patient. If you choose so, you should be able to maintain continuous control of patient's account, including negotiation of payment plans or dispute resolution directly with your patient as a key element of the collection process.

   4. Economies of Scale and Fees
      • Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
      • Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency must continue to pursue payment of all debts through any and all legal means available, including wage garnishment, bank account seizures, or, in rare cases, arrest. Success fees vary from 30% to 50% of recovered debt.
      • Even Focus Regardless of Balance Size. Collections solution must be effective for all balances regardless of amount owed.

   5. Interaction between Bil
      Shave Years Off Becoming Successful On The Internet
      Look at all the most successful athletes and business people, they ALL have coaches. So what does that tell you? Well, for one thing, stop being so darn independent!Ever since childhood we were taught in school to NEVER look at another student's test or discuss how to solve a problem. Sure there are times when you worked together when working on fun kid projects in the classroom and singing "Yankee doodle" together, but for the most part they wanted us to think for ourselves.Unfortunately that's not how the real world works if you want to be a success more quickly and easily. To put it simply, you are not the smartest person in the world and you cannot possibly do everything by yourself.You readily accept this fact if you wanted to learn how to play the piano, martial arts, or sports because you know you need a coach. If you don't, and if you are not a prodigy, then you are going to waste years of your life trying to be cheap and doing everything by yourself.Yet when it
      roach to customer service recovers on average 15% of outstanding debt.

      Key debt collections agency selection issues revolve around industry knowledge, performance, control, costs, and interaction between billing and collections services:

      1. Specialized Industry Expertise
         • Compliance and Certification. HIPAA-compliant medical record processing and legal compliance with federal and state collections regulations.
         • "Skip-tracing." Ability to find patients that changed addresses or names
         • Access to Special Funding Sources. Experience of working with specialized public and private funds for victims of accidents and violence
         • Relevant Legal Expertise. Access to specialized legal expertise and ability to handle both small and large debt cases in court
         • Understanding of Billing Processes Knowledge of healthcare claims processes and ability to successfully negotiate with insurance companies

      2. Proven Performance
         • References. Provide a list of specialty-relevant references.
         • Quantitative Performance Measurement. Compare collections performance including percent collected and time to account liquidation.
         • Client satisfaction. Demonstrate long client retention history.

      3. Centralized Control
         • Transparency. Provide real time status on all collection activities, including amount collected, actions taken, and patient responses. Include a wide selection of reports available over a secure Internet connection 24 x7.
         • Tight Cash Flow Control. All collected money goes directly to your practice or bank account, increasing positive cash flow and immediately collecting interest. No waiting for a collection agency to take its percentage first and pay you at its convenience.
         • Lower Risk with Indemnification. Collections agency must indemnify your practice from lawsuits resulting from collection efforts through a written hold-harmless agreement.
         • Flexible Contact Style. Avoid offending your patients. Collections agency must be able to vary its patient contact style (e.g., diplomatic or intensive) on a patient-by-patient basis according to your specific direction.
         • Patient Relationship Maintenance. Collections agency must not intrude on your relationship with your patient. If you choose so, you should be able to maintain continuous control of patient's account, including negotiation of payment plans or dispute resolution directly with your patient as a key element of the collection process.

      4. Economies of Scale and Fees
         • Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
         • Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency must continue to pursue payment of all debts through any and all legal means available, including wage garnishment, bank account seizures, or, in rare cases, arrest. Success fees vary from 30% to 50% of recovered debt.
         • Even Focus Regardless of Balance Size. Collections solution must be effective for all balances regardless of amount owed.

      5. Interaction between Bil
         Designing your Marketing Postcard
         Due to the limited space on a postcard, you have to think very well on what to include on your postcards design. The layout of your design as well as the copy that you would be placing on your ad would play a very significant part on its effectiveness.On creating the layout for your postcards design, make it simple so as not to confuse your readers on what you are trying to convey. Do not waste the white space so as to avoid the look of clutter on your postcard. Place your headlines where it should be as well. This could help in making your postcard a success. Be consistent with your design as well so that it would be recognizable. Limit the use of graphics to what is only necessary. Add graphics if they can aid convey the message to your readers.Try to limit the size of your postcard as well within the standard size of 4 ?” x 6” to avoid excess charges. Even if a larger sized postcard would guarantee higher visibility and may attract more attention, try to stick within your budget.A
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      6. Centralized Control
         • Transparency. Provide real time status on all collection activities, including amount collected, actions taken, and patient responses. Include a wide selection of reports available over a secure Internet connection 24 x7.
         • Tight Cash Flow Control. All collected money goes directly to your practice or bank account, increasing positive cash flow and immediately collecting interest. No waiting for a collection agency to take its percentage first and pay you at its convenience.
         • Lower Risk with Indemnification. Collections agency must indemnify your practice from lawsuits resulting from collection efforts through a written hold-harmless agreement.
         • Flexible Contact Style. Avoid offending your patients. Collections agency must be able to vary its patient contact style (e.g., diplomatic or intensive) on a patient-by-patient basis according to your specific direction.
         • Patient Relationship Maintenance. Collections agency must not intrude on your relationship with your patient. If you choose so, you should be able to maintain continuous control of patient's account, including negotiation of payment plans or dispute resolution directly with your patient as a key element of the collection process.

      7. Economies of Scale and Fees
         • Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
         • Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency must continue to pursue payment of all debts through any and all legal means available, including wage garnishment, bank account seizures, or, in rare cases, arrest. Success fees vary from 30% to 50% of recovered debt.
         • Even Focus Regardless of Balance Size. Collections solution must be effective for all balances regardless of amount owed.

      8. Interaction between Bil
         Bismarck Employment Agency
         The City of Bismarck has a huge potential of human resources. Technical staffing demands are increasing rapidly in the city. As a result more and more companies are partnering with various employment agencies operating from the city. Most of the agencies in Bismarck recruit professionals by locating, selecting, screening and mobilizing the talent of a candidate according to the employer. The extensive screening process helps the employer get qualified and skilled professionals. These agencies also manage the workforce of a company to maximize productivity and reduce costs.The employment agencies in Bismarck serve the industries in the field of Engineering, Aviation, Environmental, Architecture, Administrative, Automotive, Energy, Manufacturing, Construction, Mortgage Banking, Contact Center, Sciences, Clinical, Labor, Accounting & Financing, etc. The employment agencies in Bismarck have become specialists in recruiting in each of the industries specific divisions. The continuous recruitment of the
         Collections Letter Generation. Generally, the procedure to collect a debt starts with a letter to the person that owes the money sent on the letterhead of collections agency or attorney firm. A letter from an attorney often results in many outstanding debts paid. Flat fees for sending such letters vary between $5 and $15 per patient per month.
      9. Aggressive Follow Up Using Legal Assistance. If the letter does not result in payment, the collections agency must begin vigorous pursuit for outstanding monies. If payment is still not made on the outstanding invoice, a complaint is filed with the courts and served personally upon the debtor requiring their appearance in court. The attorney then appears in court on behalf of medical practice to obtain an award of the amount that is owed. Although the court usually enters an award on behalf of medical practice, it is important to note that collections are not completed at the time of award. The collections agency must continue to pursue payment of all debts through any and all legal means available, including wage garnishment, bank account seizures, or, in rare cases, arrest. Success fees vary from 30% to 50% of recovered debt.
      10. Even Focus Regardless of Balance Size. Collections solution must be effective for all balances regardless of amount owed.
      11. Interaction between Billing and Collections
          • Account Transfer Decisions. The practice manager must control the flow of patient debt and all associated information from billing service to collections agency.
          • Account Transfer Mechanism. Billing service must facilitate the infrastructure for simple, timely, and effective decision-making and digital data transfer to maintain the highest likelihood of successful debt collection.
          • Separation of Labor. The collection agency taking over the unpaid patient balance deals directly with the patient and the practice, excluding billing service from remaining collections process and any associated fees.
          • Exclusion of Fees. Billing service should receive no referral or any other fees from collections agencies servicing the doctor's office. Upon account transfer away from the billing service, it should receive no fees from the medical practice for collecting the outstanding debt.