Todays Insurance is different then yesterday.  One of the new changes is deductables on previously 100% payment.

Learn to be on top of the insurance game.

Deductibles! How do you protect your practice from the risk of not being paid, while protecting your patients' finances?

It's that time of year again, you are going to notice the impact of the patient's deductibles. So how do you deal with the problem of patients having to pay out of pocket to meet their deductibles? If you don't have a policy in place to deal with this, your practice will sustain a major impact at the beginning of every year. At that point you will be playing the catch up game and scrambling to collect after the visit. You will be working harder, not smarter, which can have a significant impact on your practice.

Even those who can still afford to carry healthcare, they are finding their benefits are being cut and their out of pocket expenses are rising at an alarming rate. The impact is tremendous on Providers as well as patients. Providers must implement a "Self-Pay" policy for collections.

The deductible portion of Self-Pay is the fastest growing category and we will continue to see this increase year after year. Only after a patient meets their deductible for the year do they get to use their medical benefits. This is resulting in patients being under-insured and unable to afford the cost of healthcare.

Even if you think your "PREVENTENTIVE SERVICES" are FREE of charge, think again. The cost of these FREE services are more than likely rolled into the price of your premium. The saying "There is no such thing as a Free lunch" is very true, especially in the medical field.

While physician and pharmaceutical costs are lower in the High Deductible Health Plan (HDHP) population compared with the other groups, inpatient admissions and expenditures are significantly higher.

More and more practices are demanding and collecting the deductibles upfront for the year before the doctor will see them. No longer can the providers bill an insurance company only to have the balance turned over to the patient's responsibility, treatment is complete and you never see the patient again. Patient collections are so much more labor intensive and costly, than collecting form insurance payers, therefore; timing is crucial. Be sure you are familiar with the payers plan as several will not allow you to collect from the patient before the claim has been adjudicated.

Communication with your patient about your payment expectations is the Key Factor!

OK!... but How?

First of all be sure your patients understand what they are responsible for. Unfortunately, health care policies are often confusing and complicated, leaving patients disoriented as to what they will have to pay for when visiting your office. According to McKinsey & Company, providers can expect to collect only 50 to 70 percent of an insured patient's balance after he or she is treated.

A patient is 90% likely to pay before they see their physician, 70% likely at checkout and then it drops to 40% after they leave the medical practice.

Besides communication there are two other factors that make patients more inclined to pay:

  • Make it easy and convenient for them to pay
  • Let them know there are consequences for not paying

Next week we will continue to write about changes!

Christine Taxin
36 Abington Avenue
Ardsley New York 10502
United States of America