Speaker 1: Hi everybody, I'm Jennifer Blevins-Smith with Integral Clinic Solutions, and you're watching my YouTube channel, Navigating the Business of Medicine. Today I want to talk about patient payment plans. Now we all know that the longer a patient account balance goes, the less likely you are to collect. We also know the longer that their money sits there and you're basically floating them this credit or this amount, you lose money. It's important to try to collect within 30 days of them receiving their statement. With that being said, you're probably going to be more successful in collecting money if you can set people up on payment plans. Unfortunately, the cost of medical care has gotten really, really high, but so has everyday living expenses, groceries, gas, cars, lease, rent payments, mortgage payments, and people unfortunately are not prioritizing medical bills when it comes to money spending. People are more willing to spend money on fun things like vacations, new iPhones, new TVs, computers, et cetera. There's not a lot of satisfaction from putting a few hundred dollars into a doctor bill. Now, if you let patients know upfront in your financial agreement that payment plans are a possibility and then training your staff to be using certain language, nomenclature, and offerings such as payment plans when they are having those conversations about patient cost shares, you're already ahead of the game. Depending on what specialty you are, it depends on how much you bill out. Orthopedics, dermatology, surgery are most likely going to be billing out higher visits and procedures for patients than a family practice or urgent care. That's why you need to decide if you feel this is best for your practice and how you want to have your payment plan set up. The important thing is to be consistent with everyone. Having the same expectations, the same structure, the same quote unquote penalties as you would for each and every patient, no matter what insurance they have, how much money they have, et cetera. The flexibility comes into how long you want payment plans to be and minimum payment amounts. You need to know your patient demographics as well. There are some clinics that are in more affluent areas where expecting someone to be able to pay $100 patient balance is not unheard of, but then there's other places where $100 could really put somebody out and maybe make it so they can't put food on the table for their child or put gas in their car to make it to work to earn more money. That's why taking into consideration your specialty and your patient demographics is super important when you're setting this up for your practice. The things that you really need to establish and stay true to and not waiver is how long you want to offer your payment plans. What's the minimum balance you want to start offering payment plans to your patients. And if you want to collect like a deposit or anything upfront, if you know a patient is going to accrue a large balance based on their benefits check, if they've met their deductible and how much you're going to be billing out based on the procedure or visit type and family practice. Most times we wait until the claim gets processed and the statement comes out and we ask patients to reach out to us directly if they would like a payment plan. Usually the payment plans are not longer than two or three months because the balances are generally not that high and doing minimum amounts of 20 to $25 most likely will pay that over that amount of time. Now for the higher balances, of course, our minimum balance would have to be a little bit higher or we would need to go a little bit longer in our payment plan. In order to set up patients on a payment plan, you need to have a written agreement that the patients will sign. You can't just do a verbal, or I wouldn't encourage you to do a verbal because the one true thing that really makes payment plans work is having a credit card on file. A lot of EHR and EMR systems allow you to store a credit card on file, but the good ones will remind you you should have a consent signed by the patient agreeing to allow you to do so. On those same agreements, I also put the payment plan terms. So the verbiage will be on the top about storing the credit card on file and then below it will be the details for the payment plan. It will be how much their balance is, how much they are going to pay every month for however many months it is going to be to pay off that balance, and then they get to choose when each month they would like us to automatically run that credit card payment. By storing the credit card on file, you can auto run payments. Some systems you can set this up to run automatically and other times you're going to have to have a manual process to track these in-house so that you can make sure that you're running them on those dates. People like this because they might only get paid once a month or they get paid twice a month on certain dates instead of every other. We allow them to make it so they can afford it hopefully and also show that you're being flexible because you just want to be paid basically, but you're showing flexibility. It has the account balance, how many months it's going to take to pay off based on the minimum amount due, the credit card information, and also what day of the month every month it will need to be ran. There are a few clauses that I put in there. One is if the payment is denied and we can't get a hold of the patient to get an updated form of payment because credit cards expire, things happen, it can be an honest mistake, but if they don't call you back to put on a new form of payment for you or a new credit card, then it voids the payment plan and balance is expected to be paid in full within 10 days of denied payment. If you're collecting and running those payments on the 20th of the month and the patient's credit card gets declined and you've tried to reach out to them and they're not calling you back, they have until the 30th to get that rectified or they will have to pay that balance in full by the 30th. I know this seems kind of harsh, but there has to be some kind of penalty that patients are aware of in order for them to quote unquote uphold their end of the bargain. Of course, it's up to you how you want to do this, but these are just some of my suggestions. Having an in-house payment plan is always nice as well because usually you don't charge interest. It's up to you if you want to, but that is also appealing to a lot of patients knowing that they don't have to have any interest added onto their bill. Now if you're in a specialty where you're going to be charging a ton of money, like mixing antigen serums for allergy shots in an allergy and immunology office, you can kind of predict based on the allowed amounts for the payers of how much is going to be expected from the patient out of pocket after checking their benefits. Checking whether they've hit their deductible, if billing out this will help them hit their deductible and if it's going to be subject to deductible or coinsurance or both. And then asking them maybe for a deposit at the time of service and then once they get the bill of the remaining balance to set up that payment plan with your business office. You can call the people patient account advocates instead of business office if you feel like the titles are going to help you a little bit and you know, just letting them know that you guys are flexible, but you do have certain standards that you have to work within. But within those parameters, you're happy to try to figure it out what will work best for everyone. I also have a clause on there that says if they accrue more debt or their balance gets higher after the date that the payment plan was set up that they need to call and initiate a redo basically and restructure the payment plan so that the new balance can be added in. And this might have to include increasing those monthly payment plans, but maybe stretching them out a little bit further or whatever will help them. I really hate turning away patients, especially in acute care settings because you don't want them to get to the point where they're so sick or they're so incapacitated from an injury that they're unable to work and earn money and further their financial issues. But at the same time, you are running a business and you have to keep that in mind. The consistency is really important because you don't want to ever be accused of discrimination or unfairness or anything like that. So having things in writing, training your staff on those policies and setting up those payment plans according to the policies and expectations is super important as well. If you're not sure that all your staff would be, I don't want to say able to do it, but maybe you feel more comfortable with designated people in the office actually working with patients to set up those payment plans. That's totally fine. Just know ahead of time how you want that done and make sure everybody knows and always make sure that there's a manager or yourself that's always available to for the staff to go to about payment plans. If there's questions or wrenches thrown in or whatever. It's very important that you show patients you're willing to work with them and that you understand that finances can be a struggle, but you also need to let them know that you are a business and you're doing the best that you can as well for them. Remind them there's not a lot of places that they can go and have services rendered where they don't have to pay at the time of service and it kind of gets floated to them and expected to pay down the road. Definitely making sure that you're communicating with patients that there's options. If they get a large bill and that they need to communicate with your office in order to initiate these is super, super important. Starting those conversations at the beginning, at the time of service, when you check their benefits and eligibility, it's only going to benefit you. If you have any experience with setting up patient payment plans in your office already, if you're already operating, please put that in the comments. If you have kind of trial and error at a few things and want to make suggestions to your colleagues, that's the perfect place to leave it. There are videos talking about properly training your front office staff and making sure that you're putting expectations to your staff when you do your training. So it goes hand in hand with this. I encourage you to watch those. Thank you for participating today. I really appreciate the support and I hope you all have a wonderful day.