When I first stated we'd send patients to collections if patients hadn't paid after 6 months. After just a short while I decided I just don't feel right about sending anyone but a select few to collections. Now the only ones I tell them to send to collections are ones who insurance reimbursed directly and they didn't forward the check to my billers, and potentially those who just don't respond after multiple mailed statements/phone calls. If the patient just says "I can't pay" or wants to pay $100/month, etc., then we work with them.
I sleep much better at night since that. The last account we sent to collections was probably two years ago.
Per my billers, they rarely recover anything sent to collections.
I'm sure some will disagree with me, but not getting paid by some patients is just the cost of doing business in medicine. It's why Medicaid was started--so physicians providing charity care to the indigent would receive some compensation. In theory our employed colleagues are providing the same free care--the only difference is the hospital is giving them a salary, which may be tied to "productivity." Still, I make more money for less work than my employed acute rehab colleagues, so ultimately I'm still coming out ahead and I can feel better knowing that at least my physician fees aren't sending people into bankruptcy--employed physicians have minimal/no control over that.
On my unit (per on my contract), I can't decline any patients for insurance reasons. But I am not obligated to provide charity care, and if I wanted to, could request any uninsured patients (such as those with only Medicare Part A, and even those the hospital admits for charity care) set up a payment plan ahead of time with my billers (ie, pre-pay for roughly 10 days of rehab). I've never done this--but I could.
For outpatinet physicians, it's a different game.
