Maintain Solid Financial Policies

A Cornerstone to a Medical or Dental Practice Collections

Third-party payers are paying less and patients are paying a higher percentage of their medical costs.  Employers and patients are opting for higher deductibles to keep their out-of-pocket premium costs at a reasonable level.  To work effectively with your patients it is becoming more important that you have a written financial policy and use it.   The following are some thoughts regarding the importance of maintaining a solid financial policy.

Financial Policies
  • Why do you need a financial policy? Collecting money directly from your patients can be the hardest money to collect.  Emotionally, it is difficult for doctors and their staff to deal with patients and their financial matters.  A financial policy provides a set of procedures that will help you with your collections.  This written document provides you and your staff with the methods and best procedures needed  to service your patients when collecting from them directly.  Being most effective in this process is key – it will keep you in the business of caring for your patients.
  • What are some best practices for communicating our financial policy to patients? First and foremost, the policy should be in writing. Use simple, words.  Use Microsoft Word or similar program to assess the reading level of your document.  For best practices, your document should have a reading level no higher than the seventh grade.

All of your staff should be educated and have a complete understanding of the policies.  Everyone in the office should know how to collect money from a patient.  Having clear, consistent, and firm policies are crucial to having an effective policy that patients will understand and respect.

Best practices include communicating your financial policies and your expectations to the patients when they are scheduling an appointment.  Include a copy of the policy in their “new patient” packet that you mail to them or direct your patients to a copy on your website.  Be sure to have them sign a copy when they visit your office.  Retain the signed document at your office and provide a copy of the original to the patient for their records.

In addition to providing this to new patients, it is a good idea to remind returning patients of your policy.  If you find that it is necessary to update or change the policy, be sure to notify your patients of the policy change.   This can be done by way of a letter, notice in the office, or a notice on your website.  Use what will work best for your practice ensuring that the patient is well-informed.

  • What should the financial policy contain? Be sure to clearly indicate all the financial aspects associated with a patient’s care in your office.  For example, do you charge a no-show fee?  Are there penalties assigned if the patient doesn’t pay his co-pay at the time of service?Let the patient know, your office strives to provide the best possible care and will help the patient, using your best efforts, to obtain their maximum insurance benefit.  Remind  the patient the financial responsibility for payment is, ultimately, their responsibility.  Explain co-payments, high deductible amounts, and non-covered services must be paid at the time of service.  I recommend you have a financial arrangement agreement that will address these amounts and how they will be collected.  Also, it is important this financial arrangement is reviewed with the patient before they are scheduled for any procedure.

    Additionally, here are some other items your policy should include:

  1. The patient agrees to inform you of any address changes or updates to their insurance benefits (there should be no surprise if you ask them for a copy of their insurance card or driver’s license)
  2. The forms of payments your practice accepts (cash, debit or credit cards, checks, Care Credit)
  3. The fees charged for checks that are returned
  4. How delinquent accounts are handled
  5. Hardship application and documentation
  6. To whom the patient should direct their billing questions
  7. How patients without insurance be handled (this is especially important for dental practices)
  8. Charges for making copies of medical/dental charts
  • Office Procedures for your staff – In addition to having a financial policy and a financial arrangement agreement for your patients, I would also suggest that you have a written protocol for managing the accounts receivable.  In this document you should describe the procedures and systems that you use.  Everyone in the office should be trained on the procedures.  When someone joins your team, this written document should serve as a training system for your new hire.  This document would also become the source by which you hold your employees accountable to keeping the accounts receivable clean. This document may include items such as:
  1. How a patient credit balance is handled
  2. When a patient balance is sent to collection, what code is used to adjust the balance off the patients’ ledger
  3. What notes and alerts are put on the patients accounts when the account is in collection or when a “hardship” situation is granted
  4. The process for granting a hardship application
  5. How the aged accounts receivable balances are worked and who is responsible
  6. How the aged insurance balances are worked and reviewed and who is responsible
  7. How often billing statements are sent out
  8. What the criteria is for not sending a statement
  9. What dunning notices are used and when they should be applied
  10. The process for granting and approving patient payment adjustments
  11. How the practice management will be used to note communications and agreements with patients
  12. How to process credit cards

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Guidance on Ransom-ware Attacks

Top 10 List to Protecting Yourself from Ransomware

In July, 2016 the Department of Health and Human Services Office of Civil Rights issued guidance intended to help healthcare entities understand and respond to ransom-ware attacks.

ransom ware touchscreen is operated by businessman.

Ransom-ware is a type of malware that denies a user’s access to its electronic data by encrypting the data with a “key” known only to the perpetrating hacker.  After the malware is deployed, the hacker demands that the user pay a ransom (often the request is made in cryptocurrency, such as Bitcoin, to preserve the hacker’s anonymity) to obtain the key and decrypt the data.  However, there are no guarantees that once the ransom is paid will the hacker provide the necessary key.

According to the report issued, there have been 4,000 daily ransom-ware attacks since early 2016 (a 300% increase over the 1,000 daily ransom-ware attacks reported in 2015).  Doesn’t that seem incredible? Why would these people target businesses such as yours?  Here are some thoughts:

  • They know it’s where the money is
  • They know that they can cause some major business disruption, which will put you in a very vulnerable position
  • Because through the business their dirty deeds reach a more extensive system – networks of computers, and cloud-based systems may be impacted
  • Because small business, especially healthcare providers, are often not well prepared to deal with these types of cyber attacks

After reading the HHS report, I set out to build a checklist that would help prevent this from happening to me and you, my client.  Here is my “Top 10 List to Protecting Yourself from Ransom-ware”:

  1. Back-up your data and make sure it works!  Having a couple of backups may even be a good idea – using an external drive that is removed from your office and using a cloud-based back-up system.  Side-note: Whatever backup system you may use for Protected Patient Information be sure it is HIPAA compliant and that it follows security management process described in your policies.
  2. Keep your computer operating system up to date.  New updates are issued often that contain fixes to security issues.  The same is true for the software you use – check for updates often.
  3. Use extreme caution when you are on-line and using the Internet.  Know your sites and stay away from any pop-up ad campaigns.
  4. Never open spam mail or mail from unknown senders.  If the subject line of the e-mail I receive is empty, or, if the e-mail looks even somewhat suspicious, it gets the “shift-delete” treatment.  It doesn’t even get a chance to reside in my trash bin.
  5. Use caution when downloading files, opening files, or clicking on hyperlinks – know your sources!  If you ever do open a suspicious file by mistake, shut off your Internet connection.
  6. Have security software installed and keep your subscription up to date.  One the best ways to protect against a virus is to have defenses in place to ensure you never receive any in the first place.
  7. Keep your system locked down when you are not using it and never share your password with another user.  And, I hate to say it – don’t keep your password on a sticky note placed on your computer (yes, I see this frequently).
  8. Keep your employees privileges locked down on your network.  Make it difficult for them to do their on-line shopping, visiting unknown websites, or social media sites on your business computer.
  9. Don’t let your children or grandchildren on your computer – I’m serious! Over the years I have tried to fix more computer problems as a result of kids games and files they download.  Give them their own gaming or computer system and keep them off your computer.
  10. Don’t pay the ransom. Even if we follow the above checklist, it’s possible we could find ourselves subject to a cyber-criminal.  Paying the criminal only puts you in a position of being a repeat customer.

Computers have become an integral part of the way in which we do business today.  I find myself being in a love, hate relationship.  I love the efficiencies and conveniences they provide.   I hate the damage they can cause to relationships, work / family time, and our pocket-book.  I’m probably not going to eliminate technology from my life any time soon.  In fact, my use will likely only increase with time – so, I guess it just makes sense to be smart in the way in which we use them.  Hopefully, this checklist will help us both in making life with them just a little better and little safer.

If you are interested in receiving a copy of the HHS report,  go to for a pdf copy.

Mike DeVries is a CERTIFIED FINANCIAL PLANNER ™, Enrolled Agent,  and a Certified Healthcare Business Consultant focusing on helping healthcare professionals. If you would like to learn more about becoming a client, contact Mike at

Bake My Day – A Recipe for Patient Satisfaction

The Secrete Sauce for Marketing a Doctor's Services

He called on Mother’s Day.  “May I speak to her?”, he asked.  My jaw dropped as I listened to my fifteen-year-old daughter, who was recovering from ACL knee surgery, talk with her Orthopedic Surgeon.  He was calling just to see how she was feeling. Even though my wife provided our daughter’s current status and answered all his questions, he wanted to take a minute to talk with the patient for whom he cared. It was awesome that Dr. Steward called to check in with his patient. One might even expect such a call.  But, when he ended the conversation with my wife asking – “May I speak to her?” – he just created an awesome experience – patient satisfaction for both the patient and her parents.  It was as if he put extra sprinkles on a baked cake…marketing at its finest.

Top of Easter cake covered with white icing and sprinkled with color pops. Candy background.

Build an Exceptional Team – Start with Position Descriptions

Free Position Description Templates

Having clearly defined Position Descriptions is the first step in the process building the right team for your office.  I often receive questions from clients related to staffing issues in their office. And, I often answer their question with a question – What does your position descriptions say?

Position Description

Assess & Measure Your Hygiene Department [Podcast]

Hygiene Practice

Episode 012

Doctors Business Management Show

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Are you maximizing your Hygiene Practice? Productive, Profitable Dental Practices always have a productive hygiene department.

Your Dental Hygienist is an important member of  your team in assisting your patients with their oral care.  Under the new government health reform, which includes mandatory oral health benefits for children and young adults up to 21 years old, the role of your hygienist will continue to evolve and expand.  In addition to the role of your Hygienist and the work they do for your patients, the business aspects of this segment of your business are also very important to the overall profitability and success of your practice.  In this episode, Mike and team members, Mary Millar, RDH, BS, and Ben Lane CPA, JD discuss Measuring Key Hygiene Department Business Components to improve the bottom line of your Dental Practice.

What's good for Your Patient, is good for Your Practice. - Michael L. DeVries, CFP®, CHBC, EA Click To Tweet


Providing Staff Evalutions for Your Office Staff

Any conscientious healthcare business practitioner for various reasons can easily overlook evaluating office staff. Two basic reasons are: one, it is extra work; and second, many doctors simply believe that all is working well in their offices and do not want to “rock the boat”.  Yet, it is very important for you to know that your office is operating as efficiently as it can, and with a well-planned, routinely conducted staff evaluation program, you can achieve several advantages.

Accurately Evaluating Your Office Staff

Don’t be Fooled by Fake IRS Communications

5 things you should know about phishing scams

Be aware that fraudsters are trying everything they can to obtain your personal or business financial information.  I received a call from a doctor client who indicated that she received an e-mail from the IRS stating that they were due a refund for taxes paid.  The e-mail looks legitimate as even indicates an official looking reply to address –  The body of the email states the following:

Phishing Scam Warning Sign