Collecting More Co-Pays
As respiratory and
providers, you strive
to provide the best service
and products the industry
offers. You constantly push
the envelope by introducing
new therapies that
will satisfy the needs and
demands of the patients
entrusted in your care. For
all of this, you expect to be
paid. Go figure! Rendering
service and actually getting
paid for it shouldn’t be such
a stretch. And this article will detail a strategy to collect
what is owed you, in particular, the patient co-pay.
The typical home medical equipment interaction
begins with you, the clinical staff member,
doing your part by providing education, support and
products to a patient in the home. All that is left
is turning over the customer to the billing department
and receiving the insurance reimbursement.
But wait! There is more! We forgot the co-pay.
Here is where the roles and responsibilities of clinicians
need to overlap with billing personnel so the
company can benefit from all future collectable revenue
— and what company couldn’t use more of that. I know
you’re a clinician and not a biller. But if you allow me to
share an easy way to help your company collect co-pays
without pressure that’s integrated in your process of
providing care, would you help? Of course you would.
The top three reasons patients don’t pay their
co-pays for services rendered are as follows:
- Patients did not understand that
they would have co-pays.
- The company can’t locate
the patient after initial setup.
- Staff members really don’t know what to
say about co-pays or when to say it.
This article will help you address No. 1 and
No. 3. If you can’t locate the patient after initial
setup, collecting your co-pay is the least of your
worries. What about the asset you just lost!
Unless you have a plan in place to talk to patients early on about their co-pay responsibility, it will more
than likely go unaddressed. You must focus on the
timing, the frequency and ultimately the message that
needs to be conveyed concerning the co-pay. To help
you achieve this, use the CORE method of communication.
Discussions about co-pays must be Clear
and happen Often; they must be Reinforced by all
team members and maintain an Educational tone.
You must be sensitive to the timing of the conversation
and also consider talking to someone other than
the patient, such as a family member or significant
other. There is an order to presenting information
about the co-pay. If you bring it up too soon, you are
perceived as a money-hungry vulture. If you bring it
up too late and without the appropriate emphasis, you
will not meet the goal of collecting the co-pay. The
message must be precise and direct, yet empathetic
with and considerate of the patient. Remember, this
is likely the patient’s first experience with HME.
With so much at stake, writing a script is essential.
By scripting the message, a company ensures that
every team member will be saying similar things.
There is no way to be certain that everyone will say
the same thing, but if the message is without much
variation and without apology, the company stands a
greater chance of collecting the co-pay. Also, scripting
does not mean that you or others should be robotic
in the presentation. The script is just a guide.
You can make collecting co-pays more likely by
building a bridge that patients can relate to. Again,
this is probably their first experience with HME, but
not with medical providers, such as doctors or pharmacies,
where co-pays are common. We have all seen
the sign at the doctor’s office that says: “All Co-Pays
Must Be Paid Upon Service. Thank You! — Dr. Smith.”
This is the bridge. Patients understand co-pays for
doctors and pharmacies, and by drawing that picture
for them, they will understand your co-pay, too. Here
is an outline for a script that includes the bridge.
Start with the basic elements of the transaction:
- Get information you need from the patient
- Time and date of discharge
- Any special directions to get to the residence
- Explain what your service intentions are
- Type of equipment
- Service and care
- Time and date of delivery
- Any other instructions
Now move to medical insurance coverage:
- Confirm the patient’s current insurance coverage
- Let him know that you have verified insurance already
- Explain that HME is similar to a doctor’s visit
- State that there is a co-pay involved
- Give the dollar amount
- Ask the patient or family member how they
will pay for this at setup and share the
payment options (cash, check or charge)
- Clarify all of the previous information
and remind them about the co-pay
This method will make co-pays easier to collect.
And it’s a direct, no-hassles approach most clinicians
can support both before and after care and services
are provided. However, the process does not work
unless companies are committed to starting it during
the first conversation with the patient and continuing
it every time through the order fulfillment process
while remaining sensitive to every circumstance.
When scripts are in place, team members are
accountable and in agreement to bring up co-pays
with patients Clearly and Often. They Reinforce the
message and make it Educational. Using this approach,
I am confident that you and your team will realize
success and a steadier flow of co-pay revenue.
This article originally appeared in the Respiratory & Sleep Management June 2010 issue of HME Business.
Ty Bello, RCC is the president and founder of Team@Work LLC, which offers more than 50 years’ combined experience in assessing, developing, and coaching sole proprietorships, sales teams, C-suite executives, individuals and teams in a variety of industry settings. Bello is an author, communicator and registered coach, and can be reached at firstname.lastname@example.org for sales, customer call center, and management coaching needs. Please like Ty on LinkedIn and visit www.teamatworkcoaching.com for more information and join The Coaches Corner at teamatworkcoaching.com/coaches-corner.