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Doctors' e-billing system boosts revenue despite fewer surgeries, exec says

Cheris Craig, chief administrative officer at Urology of Greater Atlanta, says the practice has improved collections.

Susan Morse, Senior Editor

Cheris Craig, chief administrative officer at Urology of Greater Atlanta, says the practice has improved collections.Cheris Craig, chief administrative officer at Urology of Greater Atlanta, says the practice has improved collections.

A move last year by Urology of Greater Atlanta to collect payments up front and establish an e-billing automatic payment plan has resulted in fewer surgeries but greater revenue, according to Cheris Craig, chief administrative officer for urology for the practice.

Craig provided insight Thursday on the new system and offered advice about how to collect payments without alienating patients.

HFN: How much of a patient's bill are you collecting up front?

CC: We capture the copay and deductible up front. We try to collect 100 percent of patient responsibility. If they’re unable to do that, we do a minimum 25 percent of patient responsibility and it requires an automated process. What we’re doing mostly is capturing a payment method at point of service, eliminating the statement process, reducing the wait time.

HFN: How does that work?

CC: We collect their credit card or checking account information to save on file. Once the claim is adjudicated, the Navicure payment process uses the encrypted stored information and charges the money. The payments happen automatically, and the patient gets a receipt. We do that (for surgeries) and on the practice side as well. We call it e-billing. It really speeds up the claims.

HFN: What have been the results?

CC: It’s working well. The doctors were talking about our surgery numbers being down but our revenues are up. Our number of cases has decreased.

HFN: Do you attribute that to the new payment method?

CC: Yes. Our patient volume is down overall. That’s because some people don’t have insurance, or have high deductible health plans. The surgical volume has decreased, but we’re collecting more revenue.

HFN: Are patients putting off procedures?

CC: Sometimes for an elective procedure, they postpone if they can’t make their payment.

HFN: Why did you choose to go with this system?

CC: With decreasing reimbursement, general revenue is down and expenses keep going up. It became a topic at every meeting with every doctor. It eventually affects their paycheck. The solution came along at the right time.

HFN: What do the patients think of the new policy?

CC: The patients don’t seem to mind. We tell them the policy. We incentivize to pay up front, because we charge them a fee to be on a payment plan. We’ve tried to mirror other plans: 90 days is the same as cash, there’s no interest or finance charge. If they want to make six payments, we charge $100; if it’s over 12 months, they have to owe more than $500 and we charge at a higher rate.

HFN: Do you provide patients with eligibility and co-insurance information up front?

CC: Unless they ask for a specific invoice, they do not get that.

HFN: How much of the practice’s reimbursement comes from Medicare?

CC: The practice is about 50 percent Medicare.

HFN: Have you heard of issues from patients?

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CC: I thought I would have this massive (response of), ‘Why are you storing my credit card information?’ But not one patient has asked to talk to a manager, and we’re six, seven months in. I think people are used to giving out their credit card information, they’re used to PayPal.

HFN: How is the system working for the different practice sites?

CC: It works well, it’s user friendly. We have nine practice sites 200 miles apart and it’s working at all of them. It’s not a big capital expense. Navicure charges for all their services. It’s per doctor per month.

HFN: Do you have a plan in place to collect bad debts?

CC: No.

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HFN: How did the system of collecting payments work previously?

CC: We had a patient management system. We printed out a coupon book and hoped the check came every month with the coupon. Patients who don’t pay, don’t get too much attention. We have limited resources. It wasn’t necessarily a problem, but it’s always something every manager and physician keeps in the back of their mind. They would ask ‘Why can’t we have a system like PayPal?

Twitter: @SusanMorseHFN

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