By Bruce W. McCollum, Long-Term Care Project Developer
In the care industry—especially in complex, high-stakes sectors like workers’ compensation and Michigan’s Personal Injury Protection (PIP) system—providers must walk a fine line. On one side lies the need for fiscal responsibility: collecting what is owed, maintaining cash flow, and securing rate agreements that reflect the true value of service. On the other, equally vital side is the preservation and cultivation of professional relationships with those who determine future referrals—case managers, adjusters, and third-party administrators. Too often, providers sacrifice the latter in pursuit of the former, and the cost is greater than any single unpaid invoice.
The Cost of Being Overzealous:
In every organization, there’s at least one team member—often well-meaning—who prides themselves on “clearing the books.” That energy is important. However, if financial collection is pursued too aggressively, especially on old invoices that are part of long-running care plans, it can compromise essential working relationships. The adjuster who has authorized tens of thousands in services, or the case manager who’s fought internal battles to keep a high-needs patient in a particular program, may feel blindsided by a tone-deaf demand letter or a call from a third-party collections firm.
It sends a message: we’re not partners; we’re creditors.
Understanding the Long Game:
In workers’ comp and Michigan PIP, reimbursement is not just about documentation and diagnosis—it’s about trust. Case managers and adjusters are human. They remember providers who respond to problems calmly, explain their rationale professionally, and demonstrate flexibility when issues arise. They also remember providers who escalate matters quickly and disregard nuance in favor of what’s owed “right now.”
The reality is, most care providers will need these professionals again. That one old invoice might get paid with aggressive tactics, but will the next referral come through? Will that same case manager go to bat for your increased rate request six months later, or will they be reluctant, remembering how things went the last time?
Strategies for Reasoned Collections:
Care providers should build systems that allow for collection without confrontation. A few best practices include:
- Segmented Collection Approaches: Separate collections efforts into categories—routine follow-ups, rate discussions, and sensitive/high-profile cases. Not every overdue claim should be handled the same way.
- Escalate with Empathy: Before turning to aggressive measures, engage in direct communication. A respectful phone call or well-written email to the adjuster explaining the concern preserves the relationship and often yields results.
- Assign Relationship Managers: Designate someone in your organization to handle payer relations, not just collections. This person can build rapport with case managers and adjusters, smoothing the way when financial issues arise.
Documentation with Diplomacy: Keep detailed records of every service, communication, and concern—but present them in a way that supports collaboration, not confrontation.
Relationship Capital Is Real Capital:
Collections are essential—but they are not the only form of value that matters. Providers who fail to see the long-term value of their professional relationships may find themselves isolated, with referrals dwindling, or primarily coming from one source, and reputations eroding. Do you want referrals from one source and when that source dries up so does your business?
Conversely, those who balance their financial needs with professionalism and poise are remembered as partners in care—trusted, reliable, and easy to work with.
In Michigan PIP and workers’ comp, where patient outcomes are intertwined with payer cooperation, relationship capital is real capital. And in the long game of care, that kind of capital is priceless.
Bruce W. McCollum, MHA is a long-term care project developer and industry commentator, helping care providers navigate the intersection of compassionate service and operational excellence.
www.brucewmccollum.com • www.directcaretraining.com
Another Blog Post by Direct Care Training & Resource Center, Inc. Photos used are designed to complement the written content. They do not imply a relationship with or endorsement by any individual nor entity and may belong to their respective copyright holders.
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