How can I improve my copay collection?

Asked by: Amalia Luettgen  |  Last update: December 29, 2023
Score: 4.8/5 (37 votes)

6 tips for collecting co-pays and deductibles from patients
  1. Assign the responsibility to office staff.
  2. Consider the patient experience.
  3. Avoid open-ended questions.
  4. Ask for immediate payment.
  5. Offer payment options.
  6. Maintain open communication.

What are some best practices for collecting copays and deductibles?

Collecting Copays From Patients: 5 Best Practices
  • Focus on Payment at Time of Service. ...
  • Consider a Patient Responsibility Form. ...
  • Double Down Staff Training. ...
  • Leverage Technology to Make Payments More Convenient. ...
  • Help Patients Improve Their Health Insurance Literacy.

How important is it to collect copayments at the time of service?

Research shows financial success is more likely if patient copays and outstanding balances are captured at the time of service before a patient departs the facility. And it's worth it. Practices only collect 50 to 70% of patient payments after patients leave the office.

Why is copay collection important?

It's absolutely critical that you collect the fees your patients owe. You shouldn't be embarrassed or ashamed to collect fees. You're providing a valuable service and the more you waive copays, the more you're diminishing the value of your practice.

How can increasing point of service collections help decrease costs?

Reduces cost to collect

Every dollar you collect upfront is one you don't have to spend time and resources collecting after the fact. If you have systems and procedures in place for collecting upfront or at point-of-service, it simplifies the process.

Collecting Patient Co-Pays: Ensuring Compliance and Efficient Workflow

15 related questions found

How can you reduce the cost of collections?

By communicating effectively with your customers and improving their payment behavior, you can reduce your collection cost and boost your cash flow. The fourth step to reducing your collection cost is to negotiate with delinquent customers and recover your debts.

Can I lower my collections?

Occasionally, when a debt goes to collections you may be able to negotiate with the collector to accept a smaller amount than what you originally owed. An agent may decide it's worthwhile to accept partial payment now rather than go through a prolonged collection process.

What is a good copay collection rate?

According to the Medical Group Management Association (MGMA), the benchmark net collection rate is over 95%. Similarly, the American Academy of Family Physicians (AAFP) lists the average net collection rate range as 95% to 99%. The highest-performing providers achieve a minimum of 99%.

What is the correct procedure to collect a copayment?

Ask for immediate payment

The most effective approach for collecting co-pays and deductibles is to encourage patients to pay at the time of service. The longer a patient waits to provide payment, the less likely it is you'll receive the total amount owed.

What are consequences for not collecting copays from patients?

In addition to relevant laws, private payor contracts generally require that the provider collect copays and deductibles. Failure to do so without the payor's express approval would violate the contract terms and could result in claims for breach of contract or repayment.

How do you explain copay to a patient?

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”

What is the best time to collect payments from patients why?

Collecting amounts due from patients at the time of service, or at the point of care (POC), offers numerous benefits to practices, such as reducing accounts receivable, increasing cash flow, reducing medical billing and back-end collection costs, decreasing the administrative burdens of tracking and writing off bad ...

Why are copays important in healthcare?

Insurance companies use copayments to share health care costs to prevent moral hazard. It may be a small portion of the actual cost of the medical service but is meant to deter people from seeking medical care that may not be necessary, e.g., an infection by the common cold.

What is the Help Ensure Lower Patient Copays Act or the Help Copays Act?

This Act may be cited as the “Help Ensure Lower Patient Copays Act” or the “HELP Copays Act”. SEC. 2. Application of additional payments, discounts, and other financial assistance towards cost-sharing requirements.

Do all copays go towards deductible?

Copays do not count toward your deductible. This means that once you reach your deductible, you will still have copays. Your copays end only when you have reached your out-of-pocket maximum.

How do you write off a copay in simple practice?

Comments
  1. Go to the Add Insurance Payment page.
  2. Enter the client responsibility as 0, then, enter the write-off for each one of the sessions that require it from this page. You can either type in the amount in the write-off box or use the circle of arrows so the system auto-populates it for you.
  3. Click Save.

Who gets to money from copays?

Copayments, or copays, are a common form of cost sharing under many health insurance plans. Cost sharing is simply the portion of costs covered by you out of pocket. Splitting the cost of medical services between the insurance company and the policyholder keeps your monthly medical bills in check.

Who determines the copay?

How it works: Your plan determines what your copay is for different types of services, and when you have one. You may have a copay before you've finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.

What is a normal copay amount?

The amount of the copay depends on your health insurance and the type of service you're receiving. A typical copay for a routine office visit that's in-network ranges from $15 to $25 and $30 to $50 for a specialist. If you have coinsurance, the average percentage is 18% for primary care and 19% for specialty care.

What is a standard copay amount?

Copay fees vary among insurers but typically are $25 or less. For example, an insurance plan with copays may require the insured to pay $25 per doctor visit or $10 per prescription.

What is a typical collections percentage?

Best Practice Tips

The adjusted collection rate should be 95%, at minimum; the average collection rate is 95% to 99%.

What is the 11 word phrase to stop debt collectors?

If you are struggling with debt and debt collectors, Farmer & Morris Law, PLLC can help. As soon as you use the 11-word phrase “please cease and desist all calls and contact with me immediately” to stop the harassment, call us for a free consultation about what you can do to resolve your debt problems for good.

What not to do with collections?

Don't pay, don't promise to pay and don't give any payment information the collector may use later. Ask for information on the debt and say you'll call back to discuss it later. Making a single payment — even just $5 or $10 — is an acknowledgment of the debt and can have serious repercussions.

Can you remove collections without paying?

You cannot remove collections from your credit report without paying if the information is accurate, but a collection account will fall off your credit report after 7 years whether you pay the balance or not.

What is the best way to clear collections?

You can ask the creditor — either the original creditor or a debt collector — for what's called a “goodwill deletion.” Write the collector a letter explaining your circumstances and why you would like the debt removed, such as if you're about to apply for a mortgage.