Non-Medicare ABN | Manage My Practice

Why You Should Not Reward Your Billing Staff for Collections

Posted by Mary Pat Whaley on October 15, 2015

Do not incentivize and reward your billing staff for reduced days in accounts receivable, increased collections or decreased non-contractual (bad debt) write-offs!

I bet you thought I was going to say that billers are paid to do a job and they should not be incentivized for doing the job you hired them to do.

Not true – I am not against incentivizing employees to do a job at all; most people enjoy a challenge and feel great when they reach a goal.

However, when a subset of employees in your practice is incentivized for increasing revenue, you can be sure it will create resentment and low morale for the rest of your employees. Do you think word won’t get around that you’re rewarding the billers? If so, you’re completely wrong. There are no secrets in a medical office. People know what others make, and regardless of what your Employee Handbook might say, it is not grounds for termination for employees to share what they make with others.

What I do encourage you to do is to incentivize your ENTIRE staff to reduce days in accounts receivable, increased collections and decrease non-contractual (bad debt) write-offs. Ultimately, your entire staff is responsible in one way or another for collections.

Consider how each person in your practice must contribute to the overall effort to make sure collections are at goal:

Front Desk: entering/verifying demographics and picking the right insurance plan for each patient; collecting the correct amount at time of service, whether it is an exact amount or an estimate of the patient’s responsibility.

Phones/Scheduling: making new patients aware of financial policies and what will be expected at time of service (“Please remember to bring the credit card you’d like us to keep on file for you”); making sure that Medicare patients know the difference between an Annual Wellness Visit and a Complete Physical.*

All clinical staff including Physicians/PAs/NPs: making sure that the patient signs an Advance Beneficiary Notice (ABN) for any services that insurance will not pay for, regardless of whether the patient is Medicare or non-Medicare**, before the service is rendered.

Manager: addressing patient complaints that escalate to you quickly and efficiently, not giving a patient any reason not to pay; making sure you have an easy-to-read-and-understand Financial Policy*** explaining your collection at time of service policy.

Everyone: embracing a culture of Customer Service, making sure that patients are satisfied with their experience; sending a consistent message to patients that you are interested in bringing them value for their dollars and reinforcing your desire to have an ongoing relationship with them.

Complete the Contact Form here to request any of the free resources discussed in this post and listed below.

*Cheat Sheet for Medicare visits
**Non-Medicare Advance Beneficiary Notice (ABN)
***Financial Policy

Image by Samuel Zeller

Tags: how to incentivize staff, Medicare wellness visit cheat sheet, non-Medicare ABN, sample financial policy

Posted in: Amazing Customer Service, Collections, Billing & Coding, Day-to-Day Operations, Finance, Human Resources

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Why Medicare Patients May Be Asked to Pay in Full for Services

Posted by Mary Pat Whaley on July 15, 2013

Most Medicare patients believe that Medicare pays for everything they need or want at their physician’s office, but there are services that either:

Are only covered by Medicare for a specific medical need (for instance, performing a diagnostic EKG when the patient has no related symptoms)
Are only covered by Medicare at specific intervals (for instance, performing a Pap smear more often than every 24 months for low-risk women)
Are never covered by Medicare (for instance, an annual physical)

In any of the above cases, because Medicare may not or will not pay, medical practices will give the patient an Advance Beneficiary Notice (ABN) that explains what Medicare may not pay for, why Medicare may not pay for it, and what they (the patient) will be responsible for paying IF they elect to receive the service and sign the ABN stating so.

Additional Rules:

The ABN must be supplied before the service is rendered, or the practice may not bill the patient.
The practice cannot give out “blanket” ABNs that state “whatever Medicare won’t cover.”
Once the patient signs the ABN and agrees to pay for the service, the practice must give a copy to the patient, keep the original on file and use a modifier on the claim to indicate that a signed ABN is on file and available for inspection.

The signed ABN is a requirement for charging and collecting from a patient for any services the patient asks for but Medicare may/will not cover. For the same circumstances for non-Medicare patients, a non-Medicare ABN may be used.

More About Using the ABN

On Thursday July 18th, from 3-4pm EST Manage My Practice is presenting a brand new webinar – “Learn How to Use the Medicare ABN and the Non-Medicare ABN to Your Practice’s Advantage.” This is an expanded webinar with 75 minutes of content and 15 minutes of Q & A with the attendees. This 90-minute program is $99.00 per attendee. See more details below. Click here to register for “Learn How to Use the Medicare ABN and Non-Medicare ABN to Your Practice’s Advantage.”

What will I learn by attending the ABN webinar?

Six benefits of using an ABN.
How to evaluate losses due to use or non-use of the ABN.
What is medical necessity and how does it relate to the ABN?
When is an ABN required by Medicare and is it used for Medicare Replacement Plans?
How to complete the ABN form.
Using the ABN functionality in your EMR.
Workflow options for introducing the ABN to the patient.
What to do about patients who refuse to sign the ABN.
How to use the correct claim codes for the Medicare ABN.
Collecting for ABN services.
Using an ABN for commercial payers.