The old adage “if you can’t measure it, you can’t manage it,” holds especially true for the unique relationship between healthcare providers and their respective collection partners.

Before a provider selects the right medical debt collection agency and negotiates the  debt collection services agreement, they must define how that relationship will be measured to determine its effectiveness.

The first phase in performing quality review of a medical debt collection agency is using the right metrics. One best practice involves using a scorecard to measure:

  • Timeliness of collections;
  • Documentation;
  • Accuracy of accounts resolutions; and,
  • Appropriateness of patient interactions.

The first three metrics are no-brainers. But some providers omit appropriateness. That’s a mistake given that medical debt collection is intensely regulated, subject to the provider’s ethical obligations to patients and community, and scrutinized by the media that just loves to write embarrassing (and often misleading) stories about villainous debt collectors abusing sympathetic patients.

Once you get the metrics right, you next need to set the right benchmarks. If you come from a large organization, the recommended approach is to use the same benchmarks you use to evaluate your internal billing staff. If you don’t have internal staff, you might want to ask colleagues from other organizations and perhaps even the collection agency itself for help. What is the agency using to rate the effectiveness of its own people?

The final phase of quality review is interpreting the results and forming the right conclusions. For example, the fact that your internal staff score better than your outside agency could mean that you’re not getting the knowhow bang you expected from your collection agency buck; or it could simply be the result of the agency’s doing the heavy lifting while your internal staff focuses on the low hanging fruit.

Finally, you need to have a quality review strategy in mind when you hire the collection agency so you can include language in the services agreement that requires the agency to cooperate with your quality review process and furnish whatever information you need to carry it out.

For more information about how to negotiate quality review and other provisions of services agreements with medical debt collection agencies, and our sister site,, have assembled a helpful guide to negotiating services agreements with medical debt collection agencies (including a sample contract), which you can purchase here: “A Guide to Negotiating a Medical Debt Collection Services Agreement.

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