Top 5 Strategies to Improve OTC Payment Performance With Electronic Medical Billing Software

For many practices, the proportion of over-the-counter (OTC) payments has recently grown from an average of 15% to as high as 75% of total payments. Systematic OTC collections, including measurable process that emphasizes upfront collections, often yield double-digit billing performance improvement. Most importantly, a disciplined and transparent collections process improves provider-patient communications, while early payment collections are also quicker and easier. Better communications and happier patients mean better health and more profitable practice.

OTC payments include copays, fees for non-covered elective services or retail products, and any outstanding balances. Successful collections of OTC payments require measurable collections process, specialized information technology infrastructure, adequate personnel training, and discipline.

OTC payment collection performance and costs greatly depend on elapsed time between service and payment. Collections performance dependence on collections timing stems from the dynamic nature of price-value relation: initially, perception of value received is high in the patient's mind. Similarly, correlation between value and price is also high. However, OTC payment collections grows more difficult in step with fading memory of service benefit.

Systematic measurement of OTC payment quality is critical for its performance improvement. Vericle's OTC payment quality metrics include the percent of accounts receivable beyond 120 days and the time spent on collecting on old account balances. While the national average of the first metric hovers around 18%, some practices have accumulated as much as 50% of their accounts receivable beyond 120 days. The second metric measures the front-office collections efficiency and it too varies widely between few hours per month to double digit hours per week spent by front office personnel chasing unpaid OTC invoices.

According to Vericle experience, the following systematic and measurable payment collections process leverages electronic medical billing software and establishes the discipline required for double-digit billing collections improvement:

1. Publish your payment collections policy and standard responses to typical patient's objections.

2. Clarify patient statement generated by your electronic medical billing software:
   1. Make outstanding balance easily identifiable.
   2. Add specific statement about the time period expected for balance payment (typically upon service or product delivery).
   3. Include phone number to call for patient questions.

3. Use electronic medical billing software to
   1. Test patient's eligibility and coverage. The results of such a test define patient's copay prior to her arrival to the clinic.
   2. Generate front office alerts about impending patient visit with unpaid OTC balance.

4. Train clinic physicians to direct patients to front-office staff to review financial statements.

5. Train your front office to collect OTC payments:
   1. Hold your front office staff accountable by setting up specific and personal collection goals.
   2. Use electronic medical billing software to track individual front staff collections performance.
   3. Establish personal awards for accomplishing collections goals and periodically review personal collections performance.
   4. Train your office staff to receive electronic medical billing software alerts.
   5. Develop a payment collections script and rehearse it with front office staff to improve front-office staff-patient communications.

Successful OTC payment collections help patient relationship management and improve practice profitability. They require measurable collections process, specialized information technology infrastructure, and adequate personnel training and discipline.

Yuval Lirov, PhD, author of "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net Billing Technologies and Services. Vericle? unites hundreds of billing services across the nation. Its electronic medical billing software tracks payer performance from a single point of control and shares compliance rules globally. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.