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Six Ways to Maximize Copay Collections from Your Infusion Patients

Written by: Maureen Farinato on Monday, April 4, 2016 Posted in: Home Infusion

rx_drug_costsPatient copays can account for a sizeable portion of your bottom line, so collecting them is critical. But if you’ve been trying to collect copays, you know that patients are often confused, frustrated, or both about these costs. To make matters worse, many patients undergoing infusion therapy are either on a fixed income or are out of work for a long stretch of time with reduced pay or no pay at all, which makes collecting from them even more difficult.

However, by following a few practical steps, you can increase your copay collections.

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  1. Verify coverage with payers. You should be able to determine patients’ deductibles, copays, out-of-pocket limits and other details with payers, so you have a clear understanding of each patient’s financial responsibility before treatment begins.

  2. Tell patients how much they will owe. Once you have verified coverage with payers, communicate the information to patients, who may be surprised to learn that their insurance doesn’t completely cover all treatments. Supplemental policies can sometimes add to the confusion, especially if Medicare is the primary payer. For example, Medicare typically does not cover antibiotic therapy treatment. And if Medicare doesn’t pay, the supplemental policy won’t pay either. In this instance, the patient would pay all of the bill.

  3. Document that patients were informed. If you don’t already have a standard form, create one for patients to sign that indicates the total dollar amount of patient responsibility. (Depending on your software system, you may be able to generate this form automatically.) It will help during collections because the signature is a clear reminder to patients that they were made aware.

  4. Establish a consistent follow-up process. Creating a consistent system helps your collections stay on track. Mailed statements, followed by phone calls when needed, are often effective.

  5. Explore flexible payment options. Especially for patients on fixed incomes, paying in full may not be feasible. Because collecting payments until balances are paid off is generally preferable to never collecting anything at all, work with patients to find realistic options. Ask what they would be willing to pay each month. With that information, calculate how many months or years it would take to pay off the balance. A clear understanding of the obligation may change how patients want to deal with their outstanding balances.

  6. Re-evaluate your aging debts. For accounts with long-overdue balances, you may opt to negotiate to collect a portion of the balance instead of nothing at all. Determine a percentage or an amount that you feel comfortable discounting. Then contact patients to explain that you will lower the overall debt if bills are paid right away. This will increase your chances for alleviating outstanding A/R.


Are you feeling prepared to take on patient copays? With these helpful tips, you can create a more trusting relationship with your patients and grow your collections at the same time. See how Mediware Reimbursement Services can expand your collections and eliminate your self-pay headaches today!

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