Each pediatric practice should maintain financial policies and billing processes. This should contain a number of different areas including: Financial Policy, Financial Assistance Policy, Payment Plan and Payment Plan Agreement, Final Collection Notice and Approach to Patient Collections, Front Desk responsibilities, and Patient Registration process. Let’s look at each of these areas a little closer.
This policy should provide an overview of the financial policy. In general, a one page policy meets the needs of most practices. The policy should describe that the practice submits insurance claims on behalf of the patient/parent, but it is the responsibility of the parent/guardian to provide accurate insurance and demographic information and ultimately pay the bill if the insurance does not pay. The policy should describe common fees that the parent/guardian might need to pay such as bounced check fee, fee for missing an appointment, and/or other form filing fee.
Financial Assistance Policy:
This policy should describe the payment plan for parents/guardians that can not pay the entire balance due. Additionally, this policy should describe the financial hardship guidelines.
Payment Plan and Payment Plan Agreement:
The billing staff should follow the financial assistance policy related to offering payment plans to parents/guardians that are unable to pay the entire balance. The practice should maintain a consistent approach on payment plans and use a payment plan agreement that is signed by the parent/guarantor. The practice should also consider sending a payment plan letter to each family on a payment plan. This letter describes the details of the agreement. Some parents/guardians prefer to keep a credit card on file and charge the credit card.
Final Collection Notice and Approach to Collections:
Some practices choose to work with a collection agency and develop a collection approach for the practice. The practice might choose to send a 10-days to collections letter after a certain time frame and at least two patient statements. If the practice chooses this approach they should use a consistent 10-days to collection letter. The approach to financial collections is a decision that each practice leadership must decide. One approach is to send everything over a certain dollar amount to a collections company while another is to not use at all. While the practice is due the money, being too strict on collection for financial hardships and other factors can impact the view of the pediatric practice in the community (a negative view can slow the practice growth rate). On the other hand, if the practice has no follow-up or calls, there will be certain parents/guardians that will not pay their patient statements (even though they have the money).
Front Desk Responsibilities and Patient Registration Process:
The front desk team is a very important function in managing and implementing financial policies for a pediatric practice. The front desk team should understand the financial policies and provide these policies to each new family registration. Additionally, the front desk team should be obtaining all demographics, a copy of the insurance card, and complete eligibility for each and every patient. Moreover, the front desk team should be collecting all co-pays and patient balances when the family arrives at the front desk.
These are a few tips on updating financial policies in a pediatric practice. We provide a suggested packet of financial policies for our clients to consider for their pediatric practice.