Working as a Team to Get the Bill Paid

Adopting certain habits before, during and after patient visits can increase the likelihood that clients will pay for services at the time of the appointment.
Brian Faulkner, BSc(Hons), BVM&S, CertGP(SAM), CertGP(BPS), MBA, MSc(Psych), MRCVS
Published: February 13, 2018
I like to think of the space between the exam room door and the reception desk as a Bermuda Triangle of sorts. All too often, agreements about follow-up, expectations of payment and even the clients themselves “disappear without a trace” the moment the exam room empties.

Clients might become distracted by a cute puppy in the waiting area or run into someone they know — or they might just want to leave the practice before someone asks them to pay.

The mnemonic EIEIO — as in the song “Old MacDonald Had a Farm” — summarizes how to deal with the Bermuda Triangle problem:
E — Estimate if appointment cost will exceed $100.
I — Inform client if bill is more than $100.
E — Escort client back to reception area (navigate Bermuda Triangle).
I — Inform receptionist of key information (e.g., scheduling, follow-up).
O — Obtain form for insurance claim.

The Old MacDonald Method
Estimate If Appointment Cost Will Exceed $100
People are generally satisfied with veterinary bills if the fees meet their expectations. The best way to meet expectations is to set them in the first place. Many veterinarians avoid discussing money with clients because it makes them uncomfortable. I call this fear “econophobia.” Failing to give an accurate estimate is a failure to set expectations, thus risking client dissatisfaction, unpaid bills and damage to the practice’s reputation.

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We have a rule in our practice: “If you billed it, you explain it.” This is partly to help everyone take responsibility for informing clients of costs and partly because receptionists should not have to to resolve disputes about invoices they did not create. I recommend giving an estimate for any appointment that will cost the client more than $100, which in many practices is most appointments. Having worked with hundreds of practices over the years, I’ve noticed that some make estimating cumbersome and complicated. I often see underestimated surgery fees and low charges for general anesthesia.

I recommend using five grades of surgery to categorize estimates, assigning all standard procedures to one of the five categories.

Inform Client If Bill Is More Than $100
I call this the $100 rule: No client should arrive at reception, either after an appointment or to collect an inpatient, not knowing that his or her bill exceeds $100. The receptionist should not be the first person to give this news to a client.

I always price the exam before the client leaves the room. Often this is integral to dispensing medications and demonstrating how to administer them. Exam fees are added when the medications are selected. The $100 rule means that if a bill totals more than $100, the client knows that before leaving the room. (I chose $100 because it seems to be the amount that most clients will pay without commenting. The number may be higher or lower at your practice.) Failing to advise clients when the exam bill is higher than $100 may lead to exclamations of “How much?!” at reception, setting off cascade of time-consuming, emotionally uncomfortable distractions, as well as the potential for an unpaid account or, worse, a lost client.

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