Patient Billing and Conflict of Interest for Physicians

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Small physician practices are often faced with situations that may be considered as a conflict of interest. One conflict of interest could be the handling of patient payments and payment plans by the physician. Many times a physician starting out in a sole practice cannot afford to hire a full staff. Consequently, the physician and maybe one employee are responsible for handling every aspect of the practice.

It is understandable that many physicians may start out doing their own billing and collections on patient accounts in addition to providing treatment and services to their patients and possibly other job duties. However, this turns out to be a challenge for any practice, old and new, and the physician.

Why Patient Billing by the Physician Is a Conflict of Interest

A physician’s first job is to diagnose and treat symptoms, diseases, and injuries of patients to improve their health. If a physician is also tasked with billing these patients and their insurance companies there could be a real or perceived conflict of interest.

Examples of Conflict of Interest

  • An actual conflict of interest: A physician’s judgment could be clouded by an emotional relationship with a patient resulting in loss of income for the practice. A physician may not be able to separate his clinical duties with financial responsibilities. Having someone on staff that can enforce the financial policy of the medical office is essential to the overall financial success of the medical practice.
  • Perceived conflict of interest: A patient could believe that the physician is not providing quality care due to outstanding account balances. Patients should feel secure that the physician treating them will deliver the highest level of care available without prejudice. Having a clear separation of duties gives patients a sense of security that the decisions regarding their care have no relationship to the financial obligation of their account.

Removing the Physician 

Physicians who exempt themselves from billing and collections within their practice eliminate having to make uncomfortable decisions regarding patients and financial issues. It is natural to for some physicians to feel that they need to have a more professional relationship with their finances. Of course, there is nothing wrong with that. However, a healthy distance is necessary for the financial operations to be successful.

Here are five ways to stay involved with the finances of the practice

  1. Make sure front office staff is knowledgeable of your financial policy
  2. Meet with front office staff frequently to make sure policy is followed
  3. Encourage front office staff to report trends that identify opportunities for improvement
  4. Be accessible to consult front office staff on ways to handle difficult patient accounts
  5. Review financial statements weekly and monthly to understand the overall financial performance of the practice

The success of any healthcare facility depends on the strength of the medical office's financial policy. Establishing a financial policy guarantees the ability of the organization to continue to provide excellent healthcare to your patients.

Communicating the Billing Policy to Patients

Accuracy and consistency is the number one way to communicate the patient billing policy for your medical office. When patients become familiar with the processes you have in place through repetitive reinforcement, over time a certain level of understanding can develop. The best way to approach patient education is through positive communication with patients and their families.

  • Continue to inform patients of their financial responsibility prior to each visit.
  • Provide patients with a list of things to bring with them each visit.
  • Rather than waiting until the collections stage of the revenue cycle, take advantage of discussing financial issues and collecting patient payments early in the process.
  • Simplify patient bills to improve patient understanding of billing and collection materials
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