Successfully collect outstanding balances

Set expectations earlier in process

At University of Pittsburgh Medical Center’s Physician Division, “every interaction with the patient is designated as an opportunity to collect an outstanding balance,” says Karen Shaffer-Platt, vice president of the revenue cycle.

“This is a culture change, as both staff and patients regard the collection of an outstanding balance as a ‘back office’ billing function,” says Shaffer-Platt. “We are moving to a model where both patient and staff expectations are set as early as possible.”

Because the revenue cycle begins at the point of scheduling an appointment, that is when staff members begin setting the expectation of outstanding balances collection, says Shaffer-Platt. “Once you set expectations for collecting at the point of service, your staff have to follow up on those,” she says.

The chances of collecting significantly decrease after the patient leaves, emphasizes Shaffer-Platt. “In today’s economy, medical bills take a lower priority to keeping the lights on and food on the table,” she says.

After patients have received services, they often don’t see paying for these as a priority, adds Shaffer-Platt. “What incentive does the patient have to pay?” she asks. “Patients are not required to pay an outstanding balance to receive future services. Medical credit reporting is not on par with other industry credit reporting.”

The key is for patient access employees to have conversations with patients about their outstanding balances while the patient is standing right in front of them, Shaffer-Platt underscores. To accomplish this step, the department made these changes:

• Using automated telephone reminders and electronic messaging.

“By optimizing technology, we are setting the patients expectations and ‘teeing up’ the front desk for collection opportunities,” says Shaffer-Platt.

• Giving patient access employees the ability to connect patients with billing experts immediately.

“Front desk and access staff have the ability to make an appointment, right from the clinic, for the patient to be contacted by customer service for in-depth follow-up and collections,” Shaffer-Platt says.

• Redefining the balances that self-pay patients are asked for.

“Previously, this was defined as any amount that sits in patient responsibility, but we are redefining this as those balances that are only the patient’s responsibility to pay,” says Shaffer-Platt. “Self-pay will no longer include balances dropped to the patient that need intervention for the insurance company to pay.”


For more information on collecting outstanding balances, contact:

Karen Shaffer-Platt, Vice President, Revenue Cycle, University of Pittsburgh Medical Center Physician Division. Phone: (412) 432-5350. Fax: (412) 488-0040. Email: