Patient deductibles and copays are part of nearly all health insurance plans but collecting them from patients is not always simple.
In fact, 83% of physician practices with fewer than five practitioners cited slow payment from patients with high deductible plans as their top collection challenge, according to the Black Book 2017 Revenue Cycle Management Survey. And 81% said their second biggest challenge was communicating to patients their financial responsibility and payment accountability.
Currently, there are no federal regulations that state a medical practice may or may not collect deductibles or copays at the time care is provided. This has obvious advantages for increasing revenue cycles and the more efficient use of billing staff resources. However, many patients are accustomed to providing their insurance information and then waiting to receive a bill after their claim is processed by their insurance company. And it may take multiple billing cycles before the patient fulfills payment.
Whether collected up front or after the insurance claim process, collecting deductibles and copays is often uncomfortable for front office staff and patients alike. It helps for front- and back-office staff to know the patient deductible before they arrive at the clinic.
Practices that don’t check patients’ deductible amounts before filing claims often find that it becomes harder to collect the patient’s share, the longer a payment is due. When this occurs, revenue cycles are delayed during the wait for reimbursement from patients and billing staff uses valuable time making reminder calls and mailings.
To help shorten the total billing cycle, Clinic-ology offers these five tips to collecting deductibles and copays — without the awkwardness that often accompanies the request and can affect the practice-patient relationship.
1. Track patient deductibles. The deductible limit starts with each new year when most insurance plans are renewed, so in the beginning of the year be more vigilant in asking patients to self-pay at the time of scheduling an appointment. Or, check with insurance companies and share deductible information with patients. Then payment can be arranged through front office staff or a medical billing service, if your practice uses one.
2. Check insurance plans before patient appointments. Insurance plans cover preventive care without any copay or deductible requirement. It also can be difficult to determine whether a patient is covered by a deductible or copay plan. However, front office staff can learn if care is covered without a deductible or co-pay, or whether the treatment is authorized under the patient’s plan, with a call to the insurer. Yes, it takes extra time to make the calls beforehand but can save time in the long run and is a sure path to learning the precise status of the patient’s deductible status.
3. Inform patients of costs upfront. High deductibles or copays can be indicated on patient records. (Hopefully, your practice has transitioned to an electronic record management system, where this information can be entered in one field that front office staff can quickly check.) All patients should be verified for eligibility and deductible amounts upon arrival, with the details shared with the patient. Then, patients can be informed of the amount they owe for treatment before they clean the clinic. Some practices do this step even earlier in the process, when confirming the appointment with the patient.
4. Collect deductibles at the patient’s visit. This takes proper front office staff training but there is no reason not to ask for the portion of payment that is the patient’s responsibility at the time of treatment. This may feel impertinent, awkward or even rude for the staff member making the request. It doesn’t have to be. The fact is, most patients are well aware of their insurance coverage, including co-pays and deductibles. While they may not voluntarily offer that information, if your front office staff has checked their plan beforehand, informing patients of their financial responsibility is completely appropriate. Additionally, it benefits patients by avoiding billing “surprises” to a minimum and lets your patients know that your staff is on top of all the aspects of their care.
5. Develop a practice-wide policy of deductible collections. Staff can be trained to clearly communicate the practice’s policy on deductibles and copays. This policy can be provided to patients by email or text before a visit or in a printed document at the check-in time. Using an electronic health record system means all patient information is quickly accessible by staff and lets you know the exact status of a patient’s eligibility for treatment and what insurance will cover.
6. Make payments easy and convenient. The more options your practice can offer patients to pay for services, the less awkward is the request. Credit card payment is standard, but some practices allow a payment plan for patients with high deductibles. Ensure your front office is trained to explain the different payment options available in a calm, non-judgmental manner.
Clinic-ology offers online training for front- and back-office medical staff along with onsite workshops and consultations. For more information, or to schedule a free consultation, visit www.clinic-ology.com.