Q. It is deductible season again. This time of year really hurts my cash flow. What can I do to avoid this cash crunch?

A. If you are current with your billing processes, Medicare's deductible season starts the end of January and runs through February. "Current" is the key word. Some companies feel compelled to hold off on all claim filings for the first month of the year to avoid the dreaded deductible hit. I hope you have not made this choice. If you have, please release all your claims immediately. As a DME provider, chances are you will file the first bill even if you hold your claims well into February. Even if you could be 100% sure that some other provider's claim would make it in first, many times your allowable amount will be higher than the deductible amount. With Medicare's deductible at $131, there is a good chance of this occurring, resulting in at least a partial payment sooner rather than later.

Once a deductible is incurred, go after it with full intensity. Since most deductibles are paid out of pocket by the patient, the older the receivable gets, the harder it is to collect. Send the deductible bill as soon as you receive notice of it. Sometimes this is the only bill your patients will receive from you all year. Also send a brief form letter with each deductible bill explaining it and that they must pay. Be sure to include a due date on the bill--two weeks from your invoice date is appropriate. Once the two weeks have passed, consider the payment "late" and call any patient who has not paid. Since you may have to reach some people during non-working hours, try to stagger the hours of some of your staff and possibly offer some overtime to get the calls done. When you speak to someone on the phone, try to get their check or credit card information right then if you are able to process payments over the phone.

Lisa Bargmann is president of bargmann Management LLC and Homecare Collection Service.