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Online exclusive
Oct. 6, 2022
Dr. Adam Stewart

Get on the fast track to collect uninsured services

PatientSERV has an easy-to-use solution to bill, track and collect service fees

It’s a weird question, isn’t it? How much is my work costing me?

Shouldn’t work be earning money? Well, only if you’re charging for it – and actually collecting for the services you provide that are not covered by OHIP.

It’s startling to hear how many physicians do not have the answers to these questions. And, for those who actually do know the answers, it can be equally shocking to hear how little informed they are.

In 2021, the OMA partnered with PatientSERV, an easy-to-use uninsured management system to help physicians optimize the collection of uninsured services. PatientSERV is more than just a technology platform to collect payments and track annual plans (i.e., block fees). Their support offloads the time and resources normally required by staff to bill, track and collect uninsured service fees, including patient education and communication.

Many doctors shy away from thinking about charging for uninsured fees because it can ‘feel too business-like’ or ‘not why you went into medicine.’

However, charging fees for uninsured services is not necessarily about turning a profit. Rather, it is often about simply recovering your costs for the services. After all, staff time, paper, ink, postage, etc., all cost money – not to mention the value of your time as a physician. 

About PatientSERV

PatientSERV helps physicians implement intuitive, effective, data-driven and evidence-based solutions to the challenges of collecting uninsured services. With comprehensive support for clinics and patients, PatientSERV’s technology and expertise optimizes workflow efficiency and maximizes uninsured service revenue. 

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An example of an uninsured services cost associated with renewing a prescription

This is what happens when a patient would like a prescription renewed.

Patient: A patient contacts the doctor's office/clinic via phone, voicemail, email or using a portal to renew a prescription.
Staff: The staff then listens/reads the request, open the patient's chart and reviews the chart. A message is sent to the doctor with the request. This usually takes three to five minutes of staff time.

Doctor: The doctor opens the message in the patient's chart and reviews the request and chart. The prescription is sent electronically; if it is not, more paper, ink and staff time costs are incurred. This usually takes three minutes of time. 

Staff: Once the patient has been in contact about renewing their prescription, the staff bill the patient using EMR software and create an invoice that is printed or emailed to the patient. If the invoice is printed and mailed, there are additional costs associated with this (the postage and cost of materials is $1.10). When overdue payment reminders are required, these steps and costs recur. This usually takes one to three minutes of staff time.

Patient: Patients submit payment by mail or e-transfer.
Staff: The patient's account is updated by staff. If they pay by cheque or cash, staff must physically go to the bank to deposit the funds. This usually takes five minutes or more of staff time. 

Staff time $0.42/minute x 13 minutes = $5.46
Material costs per mailing $1.10
Doctor time $5/minute x 3 minutes = $15

The total uninsured service cost associated with renewing a prescription is $21.56

Take, for example, the expense involved in renewing a prescription. The time and resources for this common request amounts to approximately $22 per occurrence – and much more than that if the bill does not get paid and you need to send reminders.

Consider the growing list of services with similar workflows and costs: forms, sick notes, missed appointments, notes for physiotherapy, etc.

If you are not collecting revenue for these uninsured services, that equates to thousands of dollars of uncompensated expenses every single month. That’s per physician. The annual costs in multi-physician clinics would be measured in the hundreds of thousands of dollars.

What stage of maturity is your uninsured services program?

Considerations Undeveloped Initial Emerging Experienced Optimizing
Physician experience Limited or no awareness of costs and value of uninsured services May feel stressed, overwhelmed, and under-appreciated regarding providing and/or billing uninsured services Aware of costs and value of uninsured services

Desire to improve, but may struggle with how to do so
Aware of costs and value of uninsured services

Excited about the potential to grow
Confident, enjoyable, and stress-free

Feeling the value of service is maximized
Staff experience & tools Generally unaware of uninsured services

Limited tools to collect revenue (cash or cheques)
Inconsistent/sporadic billing

Some in-person point-of-sale tools to collect revenue

Limited tracking of outstanding balances
Mostly consistent billing

Some in-person point-of-sale tools to collect revenue

Some tracking of outstanding balances

May have trouble with overdue collection processes
Culture of awareness of importance

May have staff rewards programs and incentives

Formal process for tracking and collecting outstanding balances

Full array of payment options
Culture of awareness of importance

Staff rewards programs and incentives

Simple & effective tracking of collections/ outstanding balances

Full array of payment options
Patient experience Unaware of uninsured services

Limited or no payment options

Confused by office policies due to inconsistent billing

Some payment options available

Understands office policies re: uninsured services

Some payment options available
Understands the value of services

Easy to pay by method of choice

May have option of paying in installments
Understands the value of services

Easy to pay by method of choice 24/7

Installment payment options
Outcomes Little or no revenue collected

No bookkeeping
Unknown/limited revenue (<$5k physician year)

Disorganized bookkeeping
$5K-$15K /physician /year

Time-consuming bookkeeping

$15K-$30K /physician /year

Organized bookkeeping

$30K-$50K /physician /year or more

Simple automated bookkeeping
Annual plan (block fees) None

Impossible to implement

Seems impossible
May have tried or considered, but failed or seems impossible Successful implementation and uptake

Patients see the value
Maximized, data-driven, evidence-based setting of fee rates

Optimal rates of patient uptake

All doctors and clinics will fit somewhere along this pathway. Some are very self-aware. Others may not be. 

The vast majority of doctors are still in the early ‘Undeveloped’ or ‘Initial” stages,’ (see Uninsured services maturity matrix). I know many business-minded physician colleagues that I would have thought were quite experienced in this realm. But when we dive into the details, they haven’t even scratched the surface. Uninsured billings are inconsistent and disorganized. Physicians have no way of tracking, let alone collecting. 

Take me as an example. I’ve always been a very efficiency-driven and business-minded physician. Still, in all my years of experience and efforts, up until 2021, I had only ever progressed to the ‘Emerging’ stage. I had tried implementing annual block fees in the past, but it was difficult to administer and had minimal uptake from patients. In 2021, I signed up with PatientSERV. With their experience, guidance and technological tools, I had immediate uptake in annual plans, and my total uninsured revenues doubled in the first year. The main point here is that, even as efficient as I am, I could not achieve optimized results without PatientSERV’s help.

The key is to recognize your current state of affairs and take steps to make progress. 

No matter what stage you are at, PatientSERV has the expertise and resources to help you improve, and ultimately maximize, your value and efficiency. They can fast-track you and make your journey seamless.

Dr. Adam Stewart is a family physician who is passionate about practice management and efficiencies. He signed up as a client with PatientSERV in 2021. Seeing the success, and believing in their potential, he has recently taken on the role of physician advisor at PatientSERV.