How to Effectively Collect Patient Balances & Benefit Your Practices Bottom Line

In today’s challenging economy, many can’t afford the healthcare services they need; 26 percent of U.S. adults aged 18-64 say they or someone in their household had problems paying (or an inability to pay) medical bills in the past 12 months according to the Kaiser Family Foundation. Higher inflation rates make patients reluctant to pay copayments and deductibles. These conditions financially burden not only your patient but your practice.

The medical billing and collections process can feel both overwhelming and nearly impossible with these factors against you; especially when overloaded with other administrative tasks and responsibilities. Despite the effort required to collect compensation for provided services, research shows that patients who can pay often don’t.

A large portion of consumers with medical debts in collections show no other evidence of financial distress and ordinarily pay their other financial obligations on time; of the consumers with only medical collections tradelines, approximately 50 percent have otherwise “clean” credit reports with no indication of past delinquencies. To enable these patients to pay, increase revenue at your practice, and improve the healthcare experience, consider streamlining your medical billing and collections process.

Why Medical Billing and Collections is So Important

The medical billing and collections process is a crucial aspect to practice efficiency; cashflow fuels every business and healthcare is no exception. Improving the billing workflow will help practices maximize their income and improve time management. An accurate medical billing and collections process can either create or relieve headaches while fostering or hindering patient trust.

What is Medical Billing?

Medical coding is closely tied to medical billing, but the processes are distinct; while medical coders translate services into codes, medical billing refers to processing claims and ensuring that statements get paid. Medical billing provides billing claims to both insurance companies and patients alike; the process involves communicating between practice and insurance to ensure reimbursement.

Is the medical billing and collections process hindering the quality of care at your practice? Use the following three methods to improve billing management, increase revenue, and improve both the patient and physician experience.

1. Train Your Staff Well

An inexperienced staff presents the opportunity for revenue loss, but practice management that involves thoroughly training staff can increase the number of collections at your practice. Because the medical billing and collection process involves coordinating multiple parties, reliable communication is a critical aspect; with a confused and unsure team, things can slip through the cracks.

There are time limits to filing claims, and if your office misses deadlines, insurance companies can deny your claims. Train your staff to send before rather by a deadline in consideration of processing times that could delay the process. Allow extra time for many moving parts and factors that could potentially slow down the medical billing and collections process.

To continuously improve the performance of your medical billing staff, emphasize the importance of communication. Lead by example by placing billing information in an accessible space for both employees and patients.

Even when accurately coded, insurance companies reserve the right to deny claims; and when problems arise in the process, the chances of denial increase significantly. Your medical billing and collections process should involve ensuring your team is trained on follow-up communication. The most efficient medical billing and collections process will prioritize accuracy and allow time for review.

2. Review for Accurate Information

Mistakes lead to delays in compensation and can result in denied claims; ensure that all of your data—regarding patients, providers, and payments—is accurate to increase the efficiency of your medical billing and collections process.

Patient information should be up-to-date with any name changes and billing address relocations. Your practice must have all relevant, accurate identifying information to identify a patient’s correct provider.

Bills should be sent to the correct payer the first time—whether it be the patient or insurance provider and be accurate and transparent. A patient that understands the costs of their bill is more likely to make payments on time. Patients sometimes experience a sense of distrust that deters them from paying confusing or inaccurate bills.

There will be moments when payments are made by patients that are incorrect. An underpayment is not a complete payment; don’t let this revenue slip through the cracks. A properly trained team should know the process for following up on late or incomplete payments in the medical billing and collections process.

3. Utilize the Latest Technology

Ensure accuracy in your medical billing and collections process by using the latest technology. Your practice can use software to gather accurate data to improve future business decisions. For example, highly-accurate reports can track every service performed at your practice; these reports are an incredible way to ensure proper reimbursement and discover missed opportunities for revenue.

An advantage of modern software is that it updates as the rules do saving you time. You can also determine whether claims are likely to be accepted or denied ahead of time.

Leveraging modern technology offers many features including streamlining and automating your medical billing and collections process, tracking past payments, identifying patients behind on payments, and automating late fees.

One of the most essential advantages technology offers is the opportunity to empower patients through the medical billing and collections process. Technology can empower your patients to make payments at their convenience, whether that be online payments, offering payment plans, or patient financing.


As you consider the ways you can improve your medical billing and collections process, remember that extensive team training, reviewing for accuracy, and utilizing the most current technology can help your practice.

To completely relieve your practice of the responsibility there are a variety of options—look to medical billing agencies or patient financing services.

A streamlined system like ClearGage can increase revenue and allow your employees to focus on serving patients to provide an unprecedented quality of care.