MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.
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systems should reconcile quotes and payments, and guard against unauthorized changes. It should also give you a history of who used the fi les and when they accessed them." Policies governing payment for surgery are the most con- sistent. "When I came into the industry in 1978, surgeons were already requesting deposits—a booking fee based on the total cost of the planned surgery—and, in many cases, patients were asked to pay the full fee at least 10 working days before going into the OR," says Karen Zupko, a practice management specialist working primarily with plastic surgeons. "We do collect for surgery two weeks in advance," says Chicago-based facial plastic surgeon, Steven H. Dayan, MD, "but it isn't always practical to get payment in advance for neurotoxin and fi ller services. Until you've seen the patients and talked with them, you don't know what the charges will be. Most patients come in asking, 'What do I need?' and may leave with a little Botox, some fi ller or both. This could change with every appointment," he says. Still, counsels Majeed, it is a good policy to conduct the consultation, let your patient coordinator present and collect the charges, and then perform the services. "For this reason, both patients and practices can benefi t from creating pack- ages," she says. "Patients can buy a package, fi nance it through Prosper or CareCredit, and the practice can deduct the appropriate amount from the prepaid package at each visit." N o. 3: Do pay attention to credit card costs and protect your practice from credit card fraud. Have you upgraded your credit card system to meet the new EuroPay, MasterCard and Visa (EMV) standard? The EMV card networks developed the standard more than a decade ago, and it is widely used in Europe and other nations. Businesses in the U.S. were told the deadline to offer EMV technology was October 1, 2015, but industry experts estimated that fewer than 40% of U.S. citizens have credit cards with chips and fewer than a third of U.S. businesses had installed chip and pin terminals by that date. So why make the change in your practice? Because failure to do so could leave you holding the bag for any credit card fraud. "My recommendation is that every practice be compliant, but the transition is expensive," says Majeed. "The decision depends on how much risk the practice is willing to take. If the practice believes there is zero chance of loss, perhaps the cost outweighs the risk. If you estimate the risk at higher than 5%, compliance is essential. All fraudulent transactions stemming from a loss of credit card information through the practice become the responsibility of the party that is least EMV compliant. Credit card systems should also be PA-DSS 3.0 compliant, which means the system meets the latest payment card industry data security standards." N o. 1: Don't be a money handler. "When it comes to money, aesthetic practices need to set up an interface between the doctor and the patient," says Christina Majeed, chief product offi cer of Nextech. "It's important to hire a patient coordinator as a conduit for money matters. Patients need to view their doctors as healers, not merchants." Andrew Rosenthal, MD, plastic surgeon in Boynton Beach and Boca Raton, Florida, and medical director of Modernizing Medicine's Electronic Medical Assistant software, EMA Plastic Surgery and EMA Cosmetic, agrees. "Our patient care product coordinator presents payment information both verbally and in writing during the initial consultation," he says. N o. 2: Do adopt payment policies that refl ect the type of practice you want to run. Payment policies start with the forms of payment you are will- ing to accept and comprise details ranging from when payment is due to how you handle missed appointments. Here's a typical policy based on a review of practice websites: All cosmetic services must be paid in full on the date the service is scheduled. We accept payment by cash, debit card, personal/cashier's checks with valid ID, and Visa, MasterCard and American Express credit cards. We assess a $25 fee for each check returned because of insuffi cient funds. For your convenience we do partner with [name of patient fi nancing fi rm] which may allow you to pay for some services over time. "The forms of payment you accept can depend on the type of practice you are trying to establish," says Majeed. "If you pride yourself on being a small, high-touch practice, maybe you can get away with accepting cash and checks only and keeping overhead down. If you want to grow your practice, it will certainly be better to accept whatever form of payment is easiest for the patient. Taking credit cards is often the easiest and being able to accept payment online through your website makes payment even more convenient. For example, a patient who bought the Obagi system during an offi ce visit and loves it is more likely to buy it through you again if you offer the convenience of online purchases. You want to offer the payment type patients prefer." Every form of remuneration has its advantages and dis- advantages—even cash. "It is wise to at least consider offering a small discount for payment in cash because credit card transactions do cost you, and with cash in hand there is no risk of charge-backs or canceled checks," says Dr. Rosen- thal. "You do need a good practice management system. To minimize the risk of employee theft—something that happens more often than you would think—your reporting PAY POINTS 38 MARCH 2016 | Med Esthetics