Q3 2022 Newsletter - PMRG

The Path Forward

By Curt Hill

In 2003, three partners started PMRG. When Ron Rosenberg (since retired), Donna Connolly and I started this company, we had a vision to provide something for ophthalmologists that, in our view, was unique and missing from business side of medicine. We wanted to offer physicians the freedom to practice medicine without the headache of the often-thankless job of managing the entire revenue cycle. Not that we thought—or even endorsed—that practice owners or partners should take their eye off the ball of the financial health of the practice. Our intent was to handle it with such care and professionalism that it created real peace of mind for our clients.

Years ago, one of our clients – one that came on board with us in 2005 and is still with us today – let us know that he slept better knowing that we were taking care of things. That’s what we want for every one of you.

Over the years, as our business grew, we found ourselves competing more and more on price rather than standing on what we offer. This led to an inevitable slide back into the world of being another commodity service in a world of commodity services doing what everyone else was doing, just a little bit better. Unfortunately, our original vision on occasion took a back seat in the competition for offering the best price.

So, on the heels of one of the most difficult years of our business – the costs of doing of business continue to rise, the carriers seemingly make everything harder for all of us, and hiring has never been so difficult – we are reinvigorating our vision and what we offer you. We know you can get an outsourced billing service for less than what we charge you. Our question is this: what is the freedom and peace of mind we’re offering worth?

We will be coming to you with recommendations and requests. We are reexamining everything internally. There are processes to put in place – best practices – that we know create the best possible environment for all of us. They make it possible for us to get our work done and simultaneously provide the best business results—both for your practice, and also for PMRG. Our aim is to elevate the level of service you experience so that you really can sleep better knowing PMRG is your partner.

Collecting Patient Balances

By Jana Holt

Collecting patient balances at the time of service is a key step in your revenue cycle. If your office does not currently have policies and procedures in place for collecting from your patient at the time of the visit, it can be a challenge to implement. Some patients may push back with phrases like “I have never had to pay up front before!” or “Your office always sends me a bill!” However, consistency while implementing new payment policies for your patients will help. Patients will conform to your new policies, and most will comply.

Below are some helpful hints for collecting patient balances at the time of service.

Have solid financial policies in place and stick to them! Even if that means rescheduling a patient who is scheduled for a routine follow up or non-acute illness for non-payment.
Be prepared to require patients who have previously defaulted on a payment plan or been sent to a third-party collection agency to pay the expected balance in full at the time of service.
Run eligibility on EVERY patient at EVERY visit. This is especially important if the patient will receive any treatment or undergo a procedure at the visit.
Have an up-to-date fee schedule for your top 10-15 payers with your most-billed codes available for your front desk so they can collect accurate coinsurance and deductible amounts at the time of service.
Train your front office staff on how to collect copays from the patients at check-in (if you are not already doing this). Your check-out staff should be responsible for collecting from patients with a coinsurance and/or deductible.
As a courtesy to your patients, consider having a dedicated staff member to call patients prior to their appointments who will owe more than $100 (or any amount you determine) at the time of service, or who have an outstanding balance you will attempt to collect at the visit. This allows patients who may not be able to pay at the time of the appointment to avoid the embarrassment of having to reschedule due to a payment issue in front of a lobby full of people.
Track your staff’s collection rates through reports in your Practice Management system and reward their hard work. Use those employees as a training tool for other employees who may struggle collecting from patients at the time of service.
Be patient with your patients. Answer all their financial questions as best you can. Financial transparency is very important when patients have so many options for services in their community.
Allow for hardships. Include a process in your financial policies for patients to apply for hardship exceptions.

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