BACK TALK SYSTEMS, INC. 14998 W. 6th Avenue, Suite E-500 Golden, CO 80904-5025 800/937-3113 800/696-1165 (fax) www.backtalksystems.com Team Tip #45 MONEY MATTERS (Part I) by Susan Hoy (LadyDusty@aol.com) When I first started as the office manager of our chiropractic clinic, disorganization abounded, to put it mildly. Suffice it to say that collecting from patients and insurance companies must not have been the previous manager's primary focus. The truth is, if I had known what was ahead of me, I'm not sure I would've accepted the position. I was the proverbial Forest Gump. In other words, I didn't have a clue. I had no experience with chiropractic. In fact, I joke that I didn't even know how to spell chiropractic. But, what I did have was a great deal of enthusiasm and determination. It didn't take me too long to notice that a lot of patients owed us money, lots of money! And, these were active patients. So once we figured how much they owed us, my next job was to collect from them. I would introduce myself to the patient who owed money. The dialogue went something like this: "Hello, Mr. Malcolm, my name is Susan. I am Dr. ________'s new office manager." Most of them were glad to meet me, but did they trust me, I don't think so. The smile of delight turned to an immediate frown when the subject turned to money. "Mr. Malcolm, I notice that you owe a balance of $400 (yes, some of the active patients' balances were that high). I was wondering how you customarily pay for your visits. Looking stunned, Mr. Malcolm stumbles over his words, "I usually pay by check when the balance gets high." "Well," I say with a great deal of hidden nervousness, "I would appreciate it if you could pay your balance today. Would that be O.K.?" This scenario happened over and over again and the result was almost always the same. The patient retreated to the adjustment room, with one purpose, to get me fired. They would say something like this. "Dr. ________, I want you to know that your new office manager just asked me for money!" And good old wonderful Dr. ________ would say, "Good, that is exactly what she is supposed to do! I can't stay in business unless I pay my bills. I hired Susan to help me do just that." The patients would then pull their checkbooks out (we didn't take credit cards at that time) and begrudgingly write a check. They hated me, or at least I thought they did. And I was trying so hard to be likable, too! I was not getting off to a good start, they looked at me and they immediately saw dollar signs. The worst one of all was a young lady named Ruth. I know you have patients like Ruth. She didn't work. She lived off a trust fond, yet she never made advance appointments. In fact, she only called us when we were about to close and begged us to wait for her, since she was in so much pain. She promised she would be right there and then we would wait, and wait for her. She was condescending to the staff and she always owed large amounts of money. One evening I had sent the rest of the staff home since it was so late, and I was waiting for Ruth to check out, desperately gathering up the courage to ask her for money. She approached the desk, "Ruth," I said, "I noticed that your balance is S450, and I was hoping that you could pay it off today." She looked quite annoyed. "Susan," she said with great disdain, "I only pay my balance when the amount gets high. I hate to write small checks." Well, I sure had a solution for that... "Ruth, how about if you pay the $450 and then pay a lump sum in advance. That way you can work off your balance and it will work well for both of us." Her disdain turned to rage, "Well!" she said, "I want you to know that I will be discussing your employment with Dr. & Mrs. ________. Don't expect to keep your job for much longer." With that, she reached into her purse, pulled out her checkbook, wrote out a $500 check, wrinkled it up into a ball, and with great force, threw it into my face and slammed the door. Yes, Ruth did call Dr. & Mrs. ________. Yes, she did try to get me fired. NO, she didn't succeed. Several days later, she called me and announced that I owed her $50. I took my sweet time getting that small check to her, I can assure you! Ruth never came back to our office again, but I think she was the only patient I lost trying to collect overdue accounts. Sometimes you have to get rid of the weeds to make room for the flowers. Most of the patients paid their past due accounts. When they did, I would later approach them and say, "Mr. Malcolm, I hope I didn't offend you when I asked you for your balance owing. Dr. ________ is a great chiropractor and I am here to help organize his office. I sincerely appreciate your understanding." From that day on I gained the patient's respect, because I wasn't afraid of confrontation (or so it seemed to him). I still hate confrontation, but it's necessary at times. It can be a very valuable tool, but it must be used diplomatically, discreetly and with great caring. As I was taking the monthly statistics, just after I was assigned the collection seminar, the answer came to me as to why I had been asked to give it. Our accounts receivable are totally under control these days. I will never again allow myself to be put in that position. My front desk staff knows better than to allow balances to go unpaid, because they have the wrath of Susan to contend with. I will never again get into such an uncomfortable position with patients. I have their respect and love, and they have mine. You have to understand why you collect. I always say that your schedule is your bread and butter, but your collections are your paycheck! You may have an appointment book just bursting with patients, but if they don't pay you, you won't receive a paycheck. So, if you must, look at collecting from a very personal standpoint. Forget about your chiropractor, forget about your staff, and just think about the fact that YOU need food, shelter, and a car! My husband is a corporate jet pilot. Often, his passengers will ask him what they should do if there is an emergency. His answer is always, "Follow me!" The moral is that if he saves himself, the others will be saved also. So even if you collect to save yourself, your practice will be saved also. GET IT? Patients who owe money usually don't get better as fast. Of course, if your patients decide that they are not getting good chiropractic care, they will not get better. Once a patient drops out, you will continue sending him bills. It is like rubbing salt in his wound. Every statement generates anger and frustration. Patients who owe money, who don't get better and who drop out of care will tell others. Not only have you allowed this patient to drop out, not get better, and get angry and frustrated, now this patient is spoiling the reputation of your office! All this, because you felt uncomfortable about asking for money. It's quite simple! If you want your patients to get better and benefit from chiropractic care, then do them a favor and collect from them what they owe. You may order our new TEAM TRAINING AND PRACTICE MANAGEMENT MANUAL package, from which this article is taken, by calling 800/937-3113 today.