Chandresh Shah

Practice Financial Analysis – Part 6 – Not sending out Patient Statements

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This week is a continuation of the high-level financial analysis of your practice.

Part of this analysis involves looking into your collections and related gross collection percentages. However, collections do not always meet expectations and there are a few possible reasons you should look for:

1. Shift in your payer mix (click here for last week’s article)

2. Decline in reimbursement rates

3. Poor follow-up on unpaid insurance receivables (Insurance A/R)

4. Poor front desk collections

5. Poor claim filings

6. Not sending out patient statements

7. Poor patient receivables management (Patient A/R)

8. Possible embezzlement


This week I will be focusing on the 6th reason : Not sending out patient statements.

It is becoming clear that the largest bucket of aging and outstanding balances is patient balances. Cost of treatment is increasingly shifting to patients. Co-pays and deductibles are rising. Every practice must manage patient payments.  However, many practices fail to send out patient statements on a timely basis or are not even sending them out at all.

Patients who do not receive statements every month cannot pay their accounts. If statements are not sent, regularly at the same time each month (either through  paper statements or electronic statements), cash flow will become a problem. Let me explain what I mean below:

On Patient Outstanding Balances

Most practices seem to concentrate their follow-up on unpaid insurance accounts since they tend to represent a larger portion of the total receivable and also these unpaid accounts usually have larger balances. However, patient receivables must not be overlooked.

A quick glance through the aging report will show that older accounts will be patient outstanding balances. You must have a follow-up policy for those accounts. It is not always practical to follow-up with patients on the phone, which is why patient statements are important.

On Front Desk Collection

Another important element is to ensure that practices have appropriate front desk collection procedures when patients are scheduled and when patients come in for their appointments. Most technology solutions of practice management today allow the front desk to quickly view patient outstanding balances.

These problems are minimized if patients are received at the time of the office visit and if overdue balances are discussed with patients at the time of their office visits.

Consistency is the key

Accounts receivables can be minimized by mailing patient account statements each month. A consistent process must be established within the practice and necessary emphasis on this important part of the collection process should be given.

Patient statements  are available and each practice  should take advantage of sending electronic statements that can be emailed to patients . These electronic statements  are becoming more accessible and easy to use as it  allows  patients to  pay online so take advantage of it.

Practice staff must also be trained to answer patient questions related to their statements when they call. This means they must know the status of claims, insurance payments, patient balances, and more importantly learn proper techniques of dealing with patients to be able to collect on the phone either as payment in full or even partial payments.

Get help if needed

If the practice is very busy, you should also consider a dedicated virtual staff that can help out. It has been proven that emphasis on patient statements and balances not only helps the bottom line but also results in happier patients.

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