What Would You Do In These Practice Management Scenarios?

As we grow, we learn. At least, I hope we do. Over the years, I have indeed learned that the best lessons are from our personal experiences. Since I have this great venue to share my experiences, here are a couple of real life practice management scenarios that I would love for you to weigh in on. How would your office handle these? What would you do?  

(The names have been changed to protect the innocent.)

Scenario #1: A friend of mine has an initial office visit with her podiatrist. Upon arrival, she hands the receptionist her insurance card. Even though the card clearly states, “Co-pay: $15.00,” there is no effort to request payment. The visit is complete, she gets another appointment and leaves. A month later, she receives a statement for $15.00, which she thought she would pay at her follow-up visit the next week.

On the day of the visit, she goes directly to the desk to announce her name and hands her credit card to the receptionist to pay her bill. The receptionist looks at her and asks, “Oh, did you get a bill from our office?” After my friend replies in the affirmative, the receptionist continues, “You can pay that online by going to our website.” Confused by that response, the patient says, “Well, I’m here now so I will just pay it now.”

Clearly bothered, the receptionist reluctantly accepts the credit card, walks to the terminal and swipes it through for payment. “While I’m here,” the patient states, “I may as well pay today’s co-pay too.” In response, the receptionist quips, “No, just wait until you get a bill from our office.”

Have you ever had a similar experience? What do you think of this office’s collection policy? What is your policy for collecting co-pays or outstanding balances at the time of service? Would you ever reject a patient’s offer to pay at the time of service? Do you collect co-pays when patients arrive or as they leave? What is your advice? What would you do?

Scenario #2: My neighbor called early one morning to say that she had stepped into a shallow hole in her yard the previous evening. It was a hard, unexpected fall and apparently caused some trauma to her foot and ankle. She said her foot became very painful overnight and felt like it was “blowing up like a balloon.” Not knowing where to turn, she asked if I would please take a look at it. Sure enough, she had a great deal of inflammation as well as erythema and pain. We applied an ice pack, elevated her foot and I immediately suggested she call her podiatrist to get an X-ray and professional care.

She was a little confused because she didn’t realize that her podiatrist (who treated her in the past for occasional ingrown nail flare-ups) would be able to treat her ankle. However, she took my advice and called. She explained the circumstances and requested to be seen, even offering to come in and wait for an opportunity to see the doctor. Much to our surprise, the practice told her that Dr. DPM had no openings the same day and in fact, the soonest they could see her was four days later. She reiterated her painful symptoms. The receptionist suggested that perhaps another podiatrist could see her sooner and would she want a referral?

My neighbor hung up and went to a corner clinic for treatment and got the diagnosis of a fracture.

Have you ever had a similar experience? What do you think of this office’s emergency policy? What is your policy for patients who call with an emergency situation? How well does your office triage emergencies? What is your advice? What would you do?