Can A Doctor Refuse To Treat A Patient If You Owe Them Money

GETTING PAID

Dealing With Patients Who Don't Pay

Y'all tin requite your staff strategies for effectively enforcing your practice's payment policies.

Fam Pract Manag. 2002 May;9(5):19-20.

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Request for and collecting money from patients is amid the almost hard aspects of practice management, and the current economic downturn makes this task even more challenging.

The way your office staff handles payment problems with patients reflects on your entire exercise, and the consequence tin can have a significant effect on your staff's satisfaction and your bottom line. Here are a few tips for helping your staff manage difficult situations.

When patients don't desire to brand their co-pays

Many patients practice non sympathise that their insurance company'due south reimbursement does not cover the full toll of care. Next fourth dimension a patient says he doesn't call back he should take to pay you ("My insurance company pays you. Why do I have to pay too?"), it might aid for you or your staff member to explain, for example, that the insurance company allows $42 for the service (despite the fact that your full fee is $l) and pays yous $32 considering the patient's wellness insurance contract says he owes a $10 co-pay at each visit.

Your staff must make it clear to patients who decline to make their co-payments that they are really in violation of their contract with their insurance company. Pointing this out may help patients better understand your role in the process.

When patients say they can't pay

Now that your staff has made it articulate why the patient is responsible for paying, how tin can you aid them collect from patients who say they tin't pay?

You lot and your staff take probably heard these excuses a million times: "I don't have my checkbook [or cash or a credit card]" or "I lost my checkbook." My personal favorite is "My checkbook [or wallet, etc.] is in my automobile. I'll be right back," followed by the sound of tires screeching in the parking lot every bit your patient makes a getaway.

Some of these situations are incommunicable to deal with. For example, I do non recommend having a staff member run after a speeding car to collect a co-pay. One strategy that does work well is to give these patients pre-addressed, stamped envelopes and tell them to mail their co-pay to the office. A few may scratch out the function proper name and address and use your postage-paid envelope to pay their electrical bill, but our practice receives 96 percent of the envelopes back within two weeks, on average.

Your staff may desire to inquire patients who chronically resist paying at the fourth dimension of service for their co-pay before y'all treat them. If they have left their ways of payment in their car, this will give them time to get it.

Another good idea is to brand sure your do accepts credit cards. Credit cards take proven to be an important tool for collecting patient payments. Most patients take them, and they don't take to exist present to use them. For example, when a patient forgets to bring his wallet, checkbook and credit card to the visit, he can simply call you from habitation with a credit card number. It's user-friendly for the patient, and information technology benefits the practice.

When patients want two visits for the cost of ane

I am sure your staff has experienced this scenario: Mrs. Jones brings little Jimmy in for his check-up. She brings Jessica and Stacey along too because they both have sore throats. "The doctor won't mind," she says, as she signs in all 3 children. You reluctantly consent to seeing all iii patients and, after the encounter, give your function staff three superbills. Just when Mrs. Jones learns she owes three co-payments, she loudly protests, "But we only had one appointment, so we should only owe i co-payment. I'g calling my insurance company and reporting y'all!" You lot know you are justified in billing for all three visits, merely disarming Mrs. Jones of this is another affair.

The root of Mrs. Jones' anger could exist that she was unaware that she would be charged for each child. One way to help avoid this type of misunderstanding is to accept your staff inform the parent before the children are seen that you can make room in the doctor'due south schedule for all three children to be seen this fourth dimension but that, according to the terms of her contract with her insurer, she will be responsible for paying each kid's co-payment. Letting her know this before the children are seen makes her responsible for making the decision and gives her the data she needs to make an informed choice.

When patients get angry

People who are angry and ambitious toward you lot or your staff are actually fearful and insecure. They are afraid they won't get what they need, so they face you, guns blazing and tempers flaring, to get what they want. How can you help your staff handle them in a courteous, professional way while staying in control of their ain emotions?

Railroad train your staff to listen first. They should let the irate patient go his or her story out and accident off steam. Only later the patient has said his or her piece is he or she likely to be open up to annihilation your staff may suggest. Arbitrate besides soon and the patient may get even angrier because of the interruption. Then train your staff to take a deep jiff, step back and listen, encouraging them to avoid the temptation to match the patient's anger with their own.
Once the patient has calmed down, your staff member should assure the patient. Have the staff person explain that he or she is listening, is concerned about the patient's problem and will do everything that he or she reasonably can to help. If the problem can't immediately exist resolved, take your staff assure the patient that he or she volition meet to it that the trouble is addressed and will notify the patient of the outcome.
Make sure your staff follows up with the patient. This is essential to keeping professional integrity – yours and your staff's – intact. Trust is a big upshot in medicine; both you and your staff need to show your patients that they tin depend on your practise to help them.
Encourage your staff to not have the patient'south acrimony personally. In most cases, these patients' behavior has everything to do with fear that they won't get what they need. The combination of affliction and insecurity almost always produces fear.

When enough is enough

How much difficulty does your staff have to endure to intendance for your patients sufficiently? If, despite gentle reminders and special efforts to collect amounts due, a patient however refuses to cooperate, it may be time to belch him or her.

In our practice, we give careful consideration to whether we should discharge patients who exhibit the following behaviors:

Frequent disregard for our policies and procedures. Patients who constantly disrupt your practise non only brand life difficult for yous and your staff, but they also inconvenience those patients who exercise honor your policies.
Extreme rudeness to staff, peculiarly profane language. When patients are ill, information technology is understandable that they sometimes have short fuses, merely this doesn't requite them license to browbeat your staff.
Threats. You must take seriously whatever threats to whatever member of your clinical or function staff.
Illegal requests. This includes anything from requests for backdated work excuses to requests that yous bill services or write prescriptions using a name other than the patient'due south then that insurance will cover information technology.

Of course each of these scenarios should be taken into consideration on a example-by-instance footing. Each patient is an individual and each situation is unique.

The patient belch procedure usually entails notifying the patient by certified mail and sending a re-create of the discharge alphabetic character by regular post besides. Cheque with your practice counsel and the patient's health plan for specific guidelines regarding notification requirements.

Put policies in writing

One strategy that may help you and your staff to avoid difficulties with patients is to inform them of all your policies and procedures (not simply the fiscal ones) in writing, request them to read and sign that they'll consent to them. You tin can begin by including this in your admissions packet for new patients and make it a permanent part of each patient's chart. If y'all come beyond a patient who wants services from your practice but refuses to sign your policies and procedures form, you may want to reevaluate that relationship. If the patient is already refusing to comply with 1 of the bones rules of your practice, you lot tin can expect future struggles downwards the road.

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Maria Ciletti is a exercise administrator in Niles, Ohio.

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Copyright © 2002 by the American Academy of Family Physicians.
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