This document summarizes a presentation about maximizing front desk collections with NextGen. The presentation focuses on establishing policies, training staff to ask patients for payment, and using tools in NextGen to track collections. It provides tips for staff, including accepting multiple payment methods, establishing goals for upfront payments, creating scripts, and making staff accountable. It stresses the importance of collecting co-pays upfront to reduce costs and increase revenue.

2. Presenter: James Muir
Topic: Maximizing Front Desk
Collections with NextGen
Details:
Identify the tools and techniques to help
maximize front desk collections. Focus will be
on policy, training your staff on how to ask for
payment, and the provisions within NextGen®
to help you maximize your collections.

4. GAME!

5. Are Co-Pay’s Important?
Co-
• The average co-pay is $15*
• That’s $68,000 - $90,000 per year per doc**
• That’s 20% - 28% of a practice’s overhead
• Or, 36% - 43% of the doctor’s salary
• Or, About the administrator’s salary : )
*2005 Insurance Underwriters Inc.
** 2006 Practice Resources, Inc.

6. Is collecting up-front
up-
important?
“Some experts estimate a cost of $12 to $15 to
send a patient a statement. With $15 co-pays,
you just break even, and that’s assuming the
patient pays with the first statement.”
– Judy Capko, Author of: Secrets of the Best Run Practices

7. Cost of back-end collections
back-
• Physicians Practice estimates it costs
between $15 - $35 to collect patient
balances after the initial visit*
* www.physicianspractice.com

8. The likelihood of collecting
diminishes rapidly over time.
80
70
60
50
40
30
20
10
0
5 15 30 60 90 120 180
Days Days Days Days Days Days Days
• Rapidly diminishes after 15-30 days.
*Source: MacMillan, The Wharton School

9. How much of the total balance
do we generally collect from
the patient?
• Around 20%
• We spend a lot of money collecting that
last 20%

10. Conclusion
• We can easily lose money if we
don’t do up-front collections well

11. When is the best time to
collect the co-pay?
co-
• Studies show that patients are more
willing and happier about paying
before they receive service.
– Jeff Staads 2002
• Why is that?

12. Why don’t we (or our staff)
collect from the patient?
• I don’t know how much to collect.
• It’s too much to ask.
• It’s bad customer service.
• They look like they don’t have money.
• I’m afraid the patient will get upset.
• We just don’t ask.
– (forgot, too busy, etc.)

13. Where do we go to get the
patient’s co-pay information?
co-
• From the Patient
– Insurance Card
• In NextGen
– Insurance Screen
– Insurance Card Scan

14. NextGen Insurance Card
& Co-pay Information
Co-

15. Where do we go to get the
patient’s total balance?
• <Right-click> almost anywhere on the:
– Patient
– Encounter
• Select “Patient Balance”
• Look for the Red numbers

16. Patient Balance

17. How do we train / condition
our patient to pay up front?
• Signage
• Website
• Statement
• Financial Policy
• Cooperative effort with other practices

18. New Patients
• Send brochure / includes financial policy
• Explain financial policy on the phone
before the come in
• Call and remind them before they come
• It’s EASY because they haven’t been
conditioned yet

19. Existing Patients
• Send brochure / include *new*
financial policy
• Explain the new financial policy
– “This wont affect you at all except that
now we’re required to collect at time of
service.”
– “The only way this is gong to affect you is
that we’re now required to collect at time
of service.”

20. How do I call an remind
them before they come?
• Appointment Listing Report
– Example
• Worklog
– Example

21. Appointment Listing Report

22. Worklog

23. How do we ask for it?
• “How would you like to take care of your charges
with us today?”
• “It looks like your part is $ X, how would you like to
take care of it today?”
• “It looks like your part is $ X, how would you like to
take care of it today? – cash, check or credit card?”
• “You are coming in for X <timeframe, e.g.
tomorrow>. Your portion will be $ X. How will you
be taking care of that – cash, check or credit card?”
• “I see here from your insurance card that your co-
pay is $20, how would you like to take care of that
today – cash, check or credit card?”

24. What if they ask me “Why?”
• “Your plan requires that we collect co-pay at time of service.”
• “This wont be a problem for you [patient], you are one of our
best patients.”
• “To speed our check-out process we’ve started collecting co-
pays before you see the doctor. I see here from your
insurance card your co-pay is $20, how would you like to take
care of that today – cash, check or credit card?”
• “In order to save our patients the billing fee we are collecting
the co-pay and deductible at time of service.”
• “We just had an analysis done and the only way to keep from
adding a billing fee was to collect the co-pay and deductible at
time of service. So it saves both of us money.”

25. Situations
• Patient says they don’t have a co-pay – “Oh, maybe your right. Your
insurance card should have the co-payment amount on it, let’s take a look.”
• Patient is angry – It’s probably the situation not you – “Oh, I’m sorry.
Why are you angry?” (puts it back on them)
• Patient is frustrated with new policy – (sympathize) – “Oh, I agree. I
wish my insurance would pay for everything too. My insurance has raised
my co-pay twice since I started. How would you like to take care of it?” or
“I’m sorry, your insurance company requires that we collect at time of
service. How would you like to take care of it?”
• Checkbook is in the car – (be courteous) – “Oh, no problem, I’ll wait here
while you go get it.”
• Left cash & checkbook at home – “Oh, no problem, do you have your
ATM or Visa?” or “Oh, no problem, there is an ATM right down the…”
• You are clearly not going to get the money – (make it personal) – “Oh,
well, my name is James and I’ll put my name on this envelope (pre-
addressed to the clinic) so you can send the check as soon as you get
home.”
• They say it’s not their responsibility – (if the person has authority to
present the patient - they can pay) – “Oh it’s the person who has authority
to present the patient is the one who pays. Do you have authority to
present the patient?”

26. How do we measure front
desk collections?
• Step 1: Setup Co-pay transaction Codes
– Co-pay Cash
– Co-pay Check
– Co-pay Credit/Debit
• Step 2: User-Logins
– Avoid sharing workstations (but it still can work)
• Step 3: Run Report – Daily->By Line-Item->Paymts
– Filter on your Co-pay transaction codes
– Sort by user

27. Example Co-pay report
Co-

28. James’ Top 10 Management Tips
for Maximizing Front Desk
Collections
1. Accept all forms of payment
– Use check verification service
2. Write down your standards for asking for
payment
– For both you and your patients
3. Tell your staff they will be asking patients for
payment during the interview
4. Make your front desk part of your billing staff
– Include them in meetings

29. James’ Top 10 Management Tips
for Maximizing Front Desk
Collections
5. Establish goals for time of service payments
– 98% of all copays
– 50%-75% of deductibles
– Ok to work up gradually
6. Create scripts for your staff
7. Roll Play with your staff
8. Make staff accountable
– If staff does not collect make them note why in the system
9. Create performance-based-pay (incentives)

30. #10 - Have enough staff to manage
collections at the front desk
• What happens when we don’t?
• Front desk staff tend to cost 33% - 50% of what
billing staff cost.
• SCENARIO – Additional front desk staff costs
$15/hour
– Can check in and collect from 8-13 patient’s/hour (64-104/day)
– Average $15 co-pay
– Net’s my practice $945 - $1,545 day
• Understaffing the front desk increases overhead

31. NextGen Healthcare and any presenter at the User Group Meeting is not engaged in rendering legal or other professional advice and
this presentation is not a substitute for the advice of your attorney, accountant and/or other professional advisor.