Helpful Hint - Listen to your patient

[Danni R.]

I agree, Steve. Excellent point! If it wasn't sent via certified mail there is a chance it was not received, or even received and tossed in the trash. Where is the proof? Nowhere.

[Steve Verno]

Your patient is very important to your practice and your business.  Some have no clue about the coding and billing profession and those who try to do their own investigation end up more confused at what they find.  Its like trying to find a special grain of sand on a beach. 

Patients who call the office could be calling for many reasons.  They might want to make a follow up appointment, find out test results, respond to a nasty and threatenig call from the doctor's debt collection agency or they may be questioning a bill.  If you dont talk to the patient in the beginning, you will find more work to do after the fact. 

Some patients may call because the debt collection agency is contacting them and they may or may not have received a statement from you.  While you can stand your ground and insist that you sent a statement on December 21, 2012, this doesnt mean that the patient received it.  There can be many reasons for this.  The patient may have provided an incomplete or incorrect address, your staff made errors with data entry, the address you had was good but the patient moved but left no forward address or the post office simply didnt deliver it or delivered it to the wrong address.  At one time, I believed that the post office was as displayed in the movie, "Miracle on 34th street."  However, many times i send my brother letters and packages that are never delivered or received.  He has been informed by the postal employees that if I spent more money to have the items sent by certified mail/return receipt reuested, I can be assured that the item will be delivered.  I routinely set up dummy accounts with my home and practice address, so I can see when a statement that I personally mail is received.  many times I took the mail to the post office myself and no statement was ever received.  So, now, if I verify the address as true, accurate, and correct with the patient, and they say that they never received it, the benefit of the doubt is on the side of the patient.  I never say to the patient:  Do you live at 123 Main Street?  The patient who chooses to deceive may just say yes, considering that the account shows 675 Main Street.  I ask, please give me your current address.  If they give me an address that had the statement returned to me, I know the patient is still trying to deceive me.  That is when I follow company policy.  I do not reveal that we received a mail return on the address they provided and just reconfirmed.  The policy is to enter accurate notes of the call and any bad address is sent to our debt collection agency.  They have the ability of tracing true addresses.  I once had a patient call who was sent to our collection agency because of a mail return on her address. She swore she gave us her correct address.  I verified what we had with the photo copy of her drivers license and that the address was a mail return.  She admitted she moved and that she did not inform the post office of her move so her mail could be forward to her nor did she contact the DMV as mandated by State Law.  She insisted that we did not do enough to try and find her, so she didnt have to pay the bill.  She revealed she was a lawyer and used lawyer logic which was we didnt do enough to find her.   Our lawyer sent her a letter regarding this issue.  With some patients, especially those seen at the hospital where the doctor bills separately, the patient may have actually sent the statement and they received it but they may be mistaken or confused by believing that your statement is that of the hospital itself when they  bill separately from the doctor.  Ive also had patients who said they had my statement but forgot about it and now months or years later, they came across it but forgot all about the visit. 

Again, you can stick to your guns by saying "we sent you a statement."  Listen to the patient when they say they didnt get it.  That may be a possibility.  Follow your compliance plan as to what to do when this happens.  It doesnt take much to verify the address you do have, if it is incorrect, make the corrections, enter accurate notes and send a new statement.  Understand that the fact that you do not have the correct address may not be the patients fault, it may be your fault through poor data entry with no verification of your work.  It could also be possible that if you put statements into envelopes yourself, that you might have put this patient's statement in an envelope with another patient's statement.  Its not too hard to say Im sorry and then play Montey Hall and making a deal for an online, immediate reasonable discount with immediate payment with a credit/debit card.  Just remember, cash is king.  I have approval to go as low as 50% off in certain circumstances, but 20% sounds great if you sound positive with your offer.   As an example:  You owe $200 but I can accept $150 if you wish to pay the $150 in full with your credit/debit card now.  Listening is an art and is very positive towards a good, solid patient-provider relationship.  The prevention is educating your patient on your practice financial plan and verify, verify, verify.