More vigilance over copay collections urged: expert suggests payment rules.(Practice Trends)

NEW ORLEANS -- Physicians need to get tough about collecting what's owed them, Michael Fleischman said at the annual meeting of the American Academy of Family Physicians.

"Patients may think you're the greatest thing since the public health clinic because they don't have to pay a copay if they don't want to," said Mr. Fleischman, who is principal and vice president of Gates, Moore, & Co., an Atlanta consulting firm. But there are several reasons why physicians need to be more aggressive about collecting copays.

For one thing, "your [insurance company] contract requires that you collect them," he said. In fact, some insurers use "secret shoppers" who make an appointment with a physician on the company's provider network just so they see whether the physician is routinely collecting the copay. "We've had physicians kicked off of plans ... for not [doing so]," he said.

When it comes to collecting money, a few rules need to be established, Mr. Fleischman said.

First, policies must be communicated to the patient verbally and in writing.

Second, the physician should never talk to the patient about money matters.

"Say I come to see you and I owe $75 from last time," he said. "If the staff is doing its job, they told me when I made the appointment, "Make sure you bring your $75 plus $15 for your copay," And I don't have it."