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Collect More Self-Pay Cash Up Front, Proven Front Desk Tactics

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Collect More Self-Pay Cash Up Front, Proven Front Desk Tactics

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Patient collections

If you let a patient walk out the door without paying even part of their bill, you can expect to collect only 30% of what you are dueThat’s a lot of money to lose on each patient interaction. patient collections

Every year, patients are paying more out-of-pocket due to higher deductible healthcare plans and represent a larger portion of your financial mix. There are a variety of strategies you can use to improve your self-pay patient collections. One is collecting what you are due before providing the service.

Getting paid what you’re due starts at check-in. Asking for money upfront is never easy, but it’s an essential function of your front desk staff. To make patient collections more tolerable for your front desk staff, create a process they can follow to educate patients better while asking for payment. This will improve patient communication and satisfaction. Also, it can make patients more likely to pay some or all of what they owe.

Utilize these tactics to boost your on-site patient collections rates:

Collect and Verify Insurance

The first step to maximizing patient collections at your front desk is to ensure you’ve got the most up-to-date patient insurance information. It is also essential that you verify each patient’s benefits when they check-in for their appointment.

Because most insurance plans offer online verification, this process is much faster and more accurate than it used to be. Your front desk staff, for example, may be able to see details such as how much of the patient’s deductible has been met for the year, allowing them to report this information to the individual.

Note: For more information on how to improve your preauthorization process, check out this blog post: Speed up Insurance Preauthorization with CPT Code Tracker.

Fee Schedule Driven Patient Collections

Providing your self-pay patients with an estimate of their projected amounts due can go a long way to improve collections. However, calculating what a patient will owe down to the penny is almost impossible – that’s why it is called an estimate. However, utilizing a standard fee schedule can improve the consistency and accuracy of these estimates.

To start, create an internal fee schedule chart for your front desk staff that includes the cost of your most commonly rendered services. This chart should also include what you expect patients to pay before receiving a service. Whether you ask your patients to prepay for the entire service or a percentage of it is your decision.

When setting your expected prepayment amounts, use historical data from your financials to determine how much, on average, insured patients pay out-of-pocket for the related services. Then, use a percentage of that amount as your down payment to be collected before service. With that said, there are a few things that can help your fee calculations be received more positively by patients.


Let’s say, your typical office visit charge is between $200-$250. You can certainly provide this range to the patient on their estimate, but this can cause you problems. When people receive a range of numbers, they tend to lock on to the most beneficial number for them. In this case, the $200. So, if the visit turns out to cost $250, the patient may get upset.

Accordingly, it is probably better to approximate financial obligations on the higher side. That way, when the patient receives an invoice, it has more of a chance to be lower than expected, which is always well received.

When calculating and providing an estimate of financial obligation to patients, you must be very CLEAR that it is only an approximation, not a final amount due. To help with this, have wording on your estimate that spells this out. Also, having your staff go over this issue verbally can help solidify it for the patient. Here is some wording to include on your estimate:

IMPORTANT: This is only an estimate. Although we’ve done our best to approximate your financial obligations related to your care, it’s impossible for us to plan for everything. Accordingly, your final amount due may be higher or lower than this estimate. 

Your estimate has been calculated based on your annual deductible of _______, and the amount you’ve paid toward it. If at any time you have questions, please don’t hesitate to contact us at XXX-XXX-XXXX.

Note: The No Surprises Act has specific requirements related to providing your self-pay patients with a Good Faith Estimate. You can download a free Good Faith Estimate template that is customizable for your practice.

Partial Up-Front Payments

Requiring your patients to pay even a portion of their expected amount due means they have some “skin in the game.” Even a small down payment on their services can make them more likely to continue to pay when they receive future statements. And, even if they never pay another penny, collecting something is far better than collecting nothing.

Depending on the services your practice provides, you may choose to require full payment before the service. However, be prepared to have options available for those patients who can’t afford to pay for everything but need the service to ensure their health.

Note: Don’t ever turn a patient away for not paying or having an amount due without including your provider in the decision. It could be a legal disaster if the patient has a negative healthcare issue after being turned away.

Patient Refunds are Okay

On occasion, you may need to refund some of the money that your patients have paid. This largely depends on the accuracy of your initial estimate and how much your patients pay. Providing a patient with a refund isn’t necessarily a bad thing. You would much rather have to pay a refund than chase the patient around to collect what they owe. When issuing a refund, you are in control of the money, not the patient.

However, your accounting person may not like this because it is more work for them. But don’t let the “tail wag the dog.” Although issuing patient refunds may be more internal work, it is unlikely that it costs more than you are collecting.

Staying on top of your patient collections strategy isn’t easy, but you can significantly improve your cash flow with the right plan. Get all the guidance you need to empower your front desk team to collect on patient accounts at your front desk in Healthcare Training Leader’s online training session, Boost Your Front Desk Patient Collections Quickly and Easily. In this expert-led training session, you’ll get real-world strategies to improve your patient collections with less work on your part. Sign up for this valuable training today.

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