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Mary Toomey13 November 2013
Practice Management MasterclassPrivate fees and managing debtors
PracticeManager.ieFree information websitePractice Management AdvicePractice ReviewsStaff Training Personal Leadership Coaching Management Training for GPs
A Cautionary Tale
For a time it seemed as though he made no progress
But eventually his patience paid off…
An Improved Situation
Private Fees … in six easy steps
• Agree a practice fee structure (how much?)• Agree a payment policy (when you pay?)• Display it on your walls and website (no excuses!)• Record every charge (no mistakes!)• Make sure everybody sticks to it! (no exceptions!!)• Chase up debtors right away (no escaping!!!!!)
Sample Payment Policy for Patients
“ABC Clinic aims to provide a fair and efficient service for all our patients. To facilitate this, the Clinic has adopted a policy that accounts should be settled at the time of check in for your consultation. We thank our patients for co-operating with this policy. In the event that you are attending for a special service (e.g ante-natal check up) please advise our reception so that your doctor is informed and he or she can make any necessary adjustments to your account.Please note that patients with outstanding balances are required to pay their balance in full, prior to making any further appointments. For your convenience, we accept payment by cash, cheque, debit and credit cards. If you have any queries regarding payments please contact our Practice Manager, Joe Bloggs, at (01) 234 5678.”
Policy Problems
• Policy needs to be fair and consistent• Policy should not be degrading or unethical• You can include means to deal with special
circumstances… but that doesn’t mean it’s a game to be played.
Reconcile, reconcile, reconcile• Use practice software for invoices
and receipts• Print total income each day• Use a till• Compare your takings with till
receipt and with your income report• Make sure they match!• Store securely in a drop-safe• Lodge to bank frequently• Compare with bank statement• Make sure it all matches!
Common Problems?
• Clash of medical ethics and business concerns?
• Inconsistent fees charged• Poor payment habits• Debts not well recorded• Money won’t reconcile• Mixing business income and
personal income or petty cash
Medicine and Business Won’t Mix?
The really hard part?
Sure you wouldn’t dream of charging me after all these years… with me knowing everybody in town, and playing golf with your mother every Tuesday!
The really hard part?
Life is so hard…
Surely you cannot expect me to worry about doctors’ bills when I have so many other problems…
The really hard part?
It’s a disgrace getting charged to see the doctor at my age!
Your fees are too high - I won’t pay!
Dealing with Serious Payment ProblemsDon’t ignore it – it won’t go away by itselfDon’t give debts a long head-start on youAddress it quickly, directly, honestly, but humanelyMeeting in person to discuss it is usually helpful • Agree that the problem exists• Identify cause(s) of the issue• Agree a proposal to solve the problem• Agree how you will review and what will happen
if the problem is not resolved
Think ‘effective’ not ‘efficient’ for people
• Be clear about your objective• Engage active listening• Show empathy • Get to the root of the real problems• Involve patients in problem-solving• Seek realistic solutions• Look for ‘win-win’ outcomes where possible• Agree and record a firm commitment and follow up on it
Able or Willing to Pay?
Able
Unable
Unwilling Willing
Able or Willing to Pay?
Able
Unable
Jill : Just back from Marbella, Jill is more interested in getting her gel nails refilled instead of paying for her doctors bills.
Sally : Forgot her purse yesterday in a panic when bringing her sick toddler to the surgery.
Donal : Donal has been struggling with addictions for the last few years. He recently lost his rented apartment and is now living on the street.
Joe : Previous good payer who recently lost his job and has no money until he gets his jobseeker’s benefit sorted out.
Unwilling Willing
Debt Collection Phone Calls
• Prepare for the call – have facts to hand• Introduce yourself• Get right to the point• Ask for full, immediate payment • Work through objections and excuses• Agree a commitment• End the call• Record the outcome• Set follow-up reminder
Debt Collection Phone Call Example
Mike: Good afternoon, may I speak to Mary Smith please?Mary: This is Mary speaking.Mike: Hi Mary, this is Mike from ABC Medical. I’m calling about an overdue account from your consultation on September 15th which I wrote to you about last week. I was hoping to take payment by laser or credit card today.Mary: Well Mike, I’m having some cash flow problems right now.Mike: I see. Could you make part payment today then perhaps and agree a date for full payment? I’m sure that with your co-operation we could settle it in a reasonable timeframe?Mary: I could perhaps pay €30 today and the rest in a few weeks when I get paid.Mike: That’s €30 going on your visa credit card, hold for a moment and I will confirm it goes through… thank you for your payment of €30 today. Since the account is outstanding over a month, could you please give me a specific date to expect the balance?Mary: OK. I’ll settle it by the start of December.Mike: Great. I’ll expect your cheque by 1st December – I’ve put that in my diary to follow up. If you have your card number ready, I’ll put through that €30 now.
In Summary…• Work together in your practice
to tackle income in a co-ordinated way.
• Have clear fees & payment policy and stick to them.
• Record and reconcile.• Don’t give debts a head start!• Be consistent and patient.• Individual people with problems
will take time to resolve, but overall your payment culture can be improved.
