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Patient Collections During A Pandemic: Part 2: Review Your Payer Contracts

Updated: Jul 22, 2020

Patient collections just got even harder and harder!

This is part 2 in a series of 3 blogs that discusses patient collections during a pandemic.

In this second post, I wanted to discuss another point made during a great webinar I attended, presented by Trizetto, with Susan Childs, FACMPE. Susan discussed the importance of reviewing your contacts for information about collecting money from your patients.

We have always told our clients, per your contract, you can only collect copays at the time of service and you are not able to collect coinsurance or any other money from your patients, at the time of service. We’ve advised clients to wait to collect coinsurance or other liabilities, until after the payer has processed the claim. We have told our clients this is a contractual rule, that is outlined in your contract. While this may be the case, and of course this varies from contract to contract and payer to payer, Susan brought up an excellent point that is worth consideration. Susan acknowledged this may be language in your contract, but she also says there may be other language in the contract that would allow providers to collect money, other than copays, at the time of service. One example of this language may be is:

You can collect what you can when you can during the entire billing process.

In this particular example, Susan argued the billing process begins at registration.

I don’t think any provider would disagree with the idea that the best time to collect from your patient is when they are in your office. Supporting your front office (spoiler alert, next blog) and encouraging them to collect as much as possible from your patients, at the time of service.

Contract review isn’t easy (or fun). We can help. The Billing Department, Inc. provides payer contract reviews and can help providers decide what next steps should be taken when faced with contract challenges. Contact us today for help!

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