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7 Missed Opportunities for Collecting Revenue


There are many opportunities to collect revenue in the medical office. Here are some often missed opportunities that if implemented correctly can improve your office's financial standing.

1. Billing Fees

Upfront collections is not a new concept for the medical office. Everyone knows that collection patient copays, coinsurance and deductibles prior to services being rendered to reduce bad debt and increase A/R collections. But recently health care facilities have found an inventive new way to increase revenue.

Many offices are charging a billing fee for patients that fail to pay copays upfront. This fee which could range from $5.00 to $25.00 is to pay for the administrative costs for having to bill patients after they have already received services. Before implementing this policy, make sure to post signs in your office and have patients sign stating they are aware of the new billing fee.

2. Missed Charges

Missed charges could be adding up to 5 percent of lost revenue. It doesn't sound like a lot but in large numbers 5% can add up quickly. Look at it this way - 5 percent is $5,000.00 for every $100,000.00 of revenue generated which means the more revenue being generated increases the chances for more money being lost due to missed charges.

Missed charges does not only present missed opportunities to collect revenue but also means missed tracking of supplies, labor or resources. So what can be done to reduce the chance of charges being missed from the claim?

On-going audits are one way to reduce missed charges. Many medical office's do not perform on-going audits because it is a manual time-consuming process. Audits require someone to compare the services and supplies that was charged on the claim to the information that was documented on the patient's chart.

Another suggestion is to develop a process for entering charges to the patient account. When processes are performed consistently and repetitively, there are less chances for mistakes to be made.

3. Small Balances

Small balances are generally written off because it may not be worth the costs of trying to collect it. It is important to have a small balance write off policy. The policy needs to include the amounts and how far past due the accounts must be to be eligible for the write off.

One important thing to consider is that write off accounts can still be collected on as long as it is posted to the account and the write off is reversed.

Collecting small balances does not require that money and time be spent mailing out bills and placing collection calls. One simple way to collect money on small balances is to have the front office staff and the appointment setters check patients previous balances. This way the patient can be reminded of their outstanding balance while they are in the office or on the phone.

Reminding patients that they have a $5.00 or $10.00 balance will help improve collections while clearing up past due accounts.

4. No Show Fees

Charging patients no show fees has become standard in the health care industry. When patients don't give notice, their appointment time is now a vacant slot in which no revenue is being generated.

No show fees not only make up for some of the lost revenue but also teaches your patients to give a notice if they are going to cancel their appointment. This also allows the opportunity to reschedule the appointment while the patient is on the phone.

5. Retroactive Medicaid Payments

Retroactive Medicaid payments may be eligible for patients that did not apply until after they have received health care treatment. This may be especially important for patients that are self insured and patients that claims have denied for pre-existing conditions or maximum benefits have been met.

Patients sometimes do not know they are eligible for Medicaid but your office can encourage them to apply. Many times they may apply and become retroactive eligible but fail to provide the information to your office. Run your patients information through your state Medicaid eligibility system to see if they have been approved for the retroactive period which is typically three months.

6. Bill Extra for Emergencies

Anytime your medical office is faced with squeezing a patient in between appointments because they need immediate treatment that can't wait, don't forget to charge extra. Add CPT 99058 to the claim in addition to the other services provided.

Depending on the payer, you may or may not receive full payment. Medicare and Medicaid for instance bundle services when making payments. Other payers may pay in full on the first E/M service reported and make a partial payment for each additional service.

Make sure the reason for the patient visit qualifies as an emergency service prior to billing.

7. Special Events

Generating extra revenue for your medical office can be as simple as hosting special medical events throughout the year. Charge a small fee from $5.00 - $25.00 depending on the services being offered.

  • Flu Vaccine Clinics
  • Cholesteral Screenings
  • Blood Pressure Screenings
  • STD and HIV Testing
  • Diabetes Testing
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