Payer Mix

Patient eligibility for reduced fees, the clinic’s sliding fee schedule and minimum-pay policies, and the demographics of the area the clinic serves all shape a clinic’s payer mix. Usually, at least 50 percent of a financially sustainable clinic’s payments come from Medicaid.

Capitation

Clinics that serve patients covered by capitation plans need to collect fee information on a patient basis rather than on a patient-visit basis.

Bad Debt

Bad debt must be taken into consideration when estimating revenues. Bad debt is the portion of uncompensated care that results from unpaid charges. Clinic policies on collecting fees and on scheduling appointments for patients with unpaid bills can reduce bad debt. Such policies should be consistent with the clinic’s mission.

Once you have determined your estimates, enter them on the budget planning spreadsheet. (click on toolbox icon).

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