23 Questions To Ask Before Creating A Finacial Policy For Your Medical Practice

Written by guest blogger, Mary Pat Whaley

Your financial policy is your roadmap and will determine how the practice will handle the collection of patient balances. The financial policy is the document your practice will come back to time and time again. If a question arises, ask “What does our Financial Policy say?”Screen Shot 2015-08-29 at 12.37.39 PMPublish it electronically on your website and physically in new patient packets and have your patients sign it and keep a copy of it.

Ask these questions:

  • What money, if any, will you collect before the patient is seen? Co-pays? Deductibles?
  • Will you take the patient’s word for it if they say they have met their deductible? If not, what action will you take?
  • Do any of your payer contracts stipulate that you cannot collect the deductible before the claim is adjudicated?
  • How will you handle patients with previous balances?
  • What insurance will you file? Primary? Secondary? Tertiary?
  • Will you give claim forms to patients to file themselves?
  • Will you check insurance eligibility before patients arrive?
  • What will you do if a patient arrives without their insurance card?
  • With what payers does your practice have contracts?
  • How will you handle patients who are electing to be seen out of network with reduced benefits, or out of network with no benefits
  • Can your practice management system calculate allowable charges so you can collect non-allowable charges and/or co-insurance at the check-out desk?
  • How will you disclose any fees that patients might incur (returned check fee, form completion fee, payment plan default fee, no-show fee, collection agency fee, interest or finance charges)?
  • Do you plan to offer a cash discount to self-pay patients who pay in full at time of service?
  • Do you plan to offer a financial assistance program to write-off a portion or all of the balance due to financial hardship?
  • Will you assist patients in applying for Medicaid or any other program for healthcare services?
  • What will you do if a patient checks-in without the desire or means to pay a co-pay?
  • Will you have a ready answer when a new patient calls the practice and asks how much a new patient visit will cost?
  • What will that range be?
  • Will your practice use a third-party collection agency as a last resort?
  • Will your practice dismiss patients from the practice once their account is turned over to a collection agency?
  • Will you accept all major credit cards including American Express and Discover?
  • Will you set a time limit on payment plans?
  • Will you require all balances to be paid out in 6 months, or 3 months?

Mary Pat Whaley is a blogger, consultant, and public speaker. With 30+ years managing physician practices of all sizes and specialties in the private and public sectors, Mary Pat Whaley is one of the preeminent practice management consultants in the United States today. Check out her blog managemypracrice.com for great information, like how to implement a credit card on file program in your practice.