How to Improve Copay Collection in Your Medical Practice

Collecting patient copays and balances can be one of the most challenging aspects of running a successful medical practice. With rising deductibles and healthcare costs, patients are bearing more financial responsibility for their care. This makes efficient copay collection processes more important than ever.

The good news is that with the right strategies, you can significantly improve your copay collection rates. In this comprehensive guide, we’ll explore the top techniques for optimizing copay collection in your medical practice.

Why Copay Collection Matters

Before diving into the how-to tips, it’s important to understand why copay collection matters in the first place. Here are some of the top benefits of improving your copay collection process:

  • Maximize revenue: Copays are a source of revenue that directly improves your bottom line. Leaving money on the table erodes your margins.

  • Reduce accounts receivable: Collecting copays upfront prevents balances from accruing and turning into uncollectible AR.

  • Improve cash flow: The faster you collect patient responsibility amounts, the better your cash flow will be.

  • Enhance patient satisfaction: Clear financial policies and payment expectations create a better patient experience.

  • Increase front desk efficiency: Automated workflows reduce manual billing work for your staff.

  • Optimize staff productivity: Your billing team can focus on more value-added tasks.

  • Reduce bad debt expenses: Timely copay collection lowers costs associated with chasing past-due accounts.

Simply put, improving your ability to efficiently collect copays from patients provides financial and operational benefits that can significantly impact your practice’s bottom line.

5 Strategies to Improve Copay Collection

Now let’s explore some proven strategies and best practices that you can use to improve copay collection in your medical practice:

1. Implement Upfront Collection Processes

The #1 way to optimize copay collection is to emphasize upfront collection at the time of service. This approach immediately captures patient responsibility amounts when they are in your office. Key tips include:

  • Set up registration workflow to collect copays before patients see the provider

  • Train staff to firmly but courteously request copay payment

  • Offer multiple payment options like credit card, debit card, check, etc.

  • Use scripts to explain why copay collection is a policy

  • Send pre-visit estimates and reminders to set expectations

Moving to standardized upfront copay collection processes is the most impactful strategy for improving collections.

2. Leverage Patient Responsibility Estimates

To collect upfront, your team needs to know what the patient owes. This is where real-time patient responsibility estimates can make a difference.

Solutions like eligibility verification APIs let you check a patient’s benefits and generate an estimate of their out-of-pocket costs. Staff can then collect the estimated copay amount upfront and reconcile any differences after claims processing.

Accurate real-time estimates prevent unterbilling and create a better patient financial experience.

3. Offer Payment Plan Options

While upfront collection is ideal, it’s not always possible for patients. Having payment plan options can help patients pay over time. Different plans to consider include:

  • Automated payment plans – Patients authorize scheduled payments from a card on file. This automates installments with no added staff work.

  • Staff-managed plans – Staff work with patients to arrange custom installment schedules. More labor-intensive but flexible.

  • Third-party financing – Companies like AccessOne offer 0% APR financing plans for patients. This provides flexibility while ensuring you get paid in full upfront.

Payment plans allow patients to meet obligations over time while improving your ability to get paid. The more options you offer, the higher your collection rates will be.

4. Follow Up On Outstanding Balances

Even with great upfront collection processes, you’ll inevitably end up with some outstanding patient balances. Consistent follow up is key to collecting these amounts.

Tactics like payment reminder emails, automated IVR calls, and paper statements all help spur patients to pay. You can also engage a collections agency to assist with accounts 90-120 days past due.

The higher the number of balanced billing follow-up actions taken, the more outstanding copays you’ll recover.

5. Monitor KPIs

Finally, be sure to monitor key performance indicators (KPIs) related to your copay collection efforts. Examples of metrics to track include:

  • Point-of-service collection rates
  • Patient balance aging
  • Accounts sent to collections
  • Bad debt as a percentage of revenue

By regularly analyzing these KPIs, you’ll identify opportunities to continue improving processes. If certain metrics dip, take corrective actions.

Technologies for Improving Copay Collection

In addition to process improvements, leveraging the right technologies can significantly streamline and enhance copay collection. Some top solutions include:

Patient Engagement Apps

Applications like AccessOne’s MobilePay allow you to send automated, personalized payment reminders and collect balances directly from patients via text messages. This makes paying more convenient for patients.

Real-Time Eligibility Verification

As discussed above, eligibility APIs let you check benefits and generate patient responsibility estimates on demand to support upfront collection.

Integrated Billing Systems

All-in-one solutions like practice management and revenue cycle management software centralize workflows and enable real-time patient balance visibility.

Digital Payment Acceptance

Allowing online payments via payment portals provides more convenience for patients to resolve balances.

Develop A Cohesive Copay Collection Strategy

As you can see, there are many techniques you can leverage to improve copay collection in your medical practice. The key is taking a cohesive, all-encompassing approach.

By combining optimized processes, staff training, patient communication, and the right technologies, you can significantly increase the speed, efficiency, and effectiveness of your copay collection efforts.

Start by reviewing this guide and identifying areas of opportunity in your current workflows. Develop an action plan for pilot testing incremental improvements and then monitor results before rolling changes out practice-wide.

It takes time to change engrained processes. But the financial benefits of higher copay collection rates are well worth the effort. More importantly, reducing patient balance billing frustrations creates immense value for patients as well.

Focus on transparency, convenience, automation, and consistency. With the right strategy, you can become a best-in-class medical practice when it comes to copay collections. This allows you to focus on delivering exceptional patient care with the peace of mind that financial workflows are optimized.

To learn more about potential solutions to improve front-end collections for your practice, contact AccessOne today for a free consultation!

Collecting Patient Co-Pays: Ensuring Compliance and Efficient Workflow


How do I increase my copay collection?

Perseverance is key to maximizing collections. Develop a proactive plan for contacting patients who don’t make timely payments and create a script for staff to follow. Your staff should be prepared to request payment in full, discuss payment options, and offer a payment plan if needed.

How would you educate your patients about copays collections?

Patient education: Educate patients about insurance coverage, co-pays, and deductibles. Provide written materials or online resources that explain common billing terms and processes. Clear payment expectations: Set clear expectations regarding payment due dates and consequences for late or non-payment.

What is a good copay collection rate?

The industry standard benchmark for Patient Responsibility Collection Rate is typically set at 90%. This means that healthcare providers should aim to collect at least 90% of the total amount of patient payments due.

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