I am all for using a collection agency after all means to collect from the billing department have failed. The practice I work for adds on a collection fee that covers our percentage that the agency would keep and we usually wind up collecting 100% of the balance. Those who don’t pay….well it shows up on their credit report, probably along with the all their other unpaid bills.

We do our best to inform patients of their benefits and estimated financial responsibility prior to procedures being done but it is ultimately THE PATIENT’S RESPONSIBILITY TO KNOW WHAT THEIR BENEFITS ARE.

Physicians went through all those years of schooling to practice medicine, not to be creditors.

Sadly, many patients are unilaterally terminated by physicians who “brazenly withhold services as if they can do it with impunity.” And, because most patients are entirely unaware that abandonment is considered medical malpractice, the proportion of physicians who engage in this practice is quite large compared to patients who are negligent about medical bills.

In my experience, as both a medical professional and consumer, patients who ignore the doctor-patient agreement and do not pay their bills do so because they do not have the money. On the other hand, physicians who ignore the doctor-patient agreement and unilaterally/abruptly terminate patients without providing adequate referrals do so because they do not have the empathy. (Most doctors will substitute “empathy” with “time,” but this still means that these physicians feel as though they should not be forced to spend any time helping a patient find appropriate care if they’re not being paid for that time – regardless of what the AMA or the courts have to say about the matter.)

If physicians do not start acting like healers instead of acting like dealers, then trust in the profession will never be restored, and more of these educated “consumers” will begin to realize that they’ve been victims of a type of medical malpractice they never knew existed.

Or, because physicians think with their wallets instead of their hearts, think about it this way: a few hundred dollars from collections will never be worth the outstanding costs associated with a medical malpractice lawsuit.

Just because a physician goes after money owed aggressively should not imply that they are cold, callus, Scrooges. Many of us, rural primary care docs, are just trying to pay our bills too.

I blogged on the Johns Hopkins experience last week at The Country Doc Report. (http://thecountrydocreport.wordpress.com/2008/12/23/hospitals-doctors-struggle-with-how-far-to-go-to-collect/)

Both non-profit hospitals in this town received national negative publicity several years ago for excessive use of body attachments. Afterwards, they seemed to make a greater effort to at least help patients understand financial aid options available to them — and have made that a central component of their marketing campaigns ever since. I suppose there’s some advertising value to being kind and charitable, if you want to go that route.

1: The return rate was pitiful

2: I have had experience on other side of the coin with these guys. Specifically someone with my name (different middle initial) who had unpaid debts. I would get phone calls asking my name then discussing my “debt”. I would point out they had the wrong person (including wrong middle initial) and more often than not deal with abusive responses. Folks, the people who work for these companies can be real jerks. It doesn’t matter whether they have the right person the just want $$$. Finally, when insisting on talking with a supervisor (if I was not hung up on which happened 75% of the time). I would get removed from the list. Then in two weeks I would get calls from another collection agency. The same thing would start all over again. This has gone on for more than two years. Yes people should pay there bills, but given their pathetic reimbursement to you and their abusive nature when dealing with ANYBODY (from loser to upstanding citizen having a hard time, or even the wrong person as in my case) is this who you want collectng money in your good name? I think not. IMO most people will try to work out a payment plan if you call. For the chronic non-payers, give a 30 day written certified notice (with cause) and terminate the relationship.

But I have found the collections process futile. The recovery rates are so poor as to make the effort not worth the time. And when the rare case of a debtor wanting to make payment for service occurs, once a collector is contracted, even if they make no effort to collect, they are still due their percentage.

I agree with the poster above. Your energies are best devoted to prevention. Verify insurance. Hold your staff accountable for failing to do this. Insist on deposits whenever there are issues of ineligibility or inability to confirm. Have as much protective language in your practice paperwork as is allowed to pursur other payment as in credit card payment and interest on unpaid charges. Make sure you have accurate and up-to-date demographic information. Verify employment if claimed.