Ophthalmology and Optometry Coding Alert

Question: One of our providers returned from a meeting, saying he had talked to other providers who were collecting co-pays and deductibles up front from scheduled patients. Is this an acceptable practice? If so, how does it work?

New Mexico Subscriber

Answer:  Some physician groups do collect patient co-pays and co-insurance payments prior to office visits and surgery. Some also collect deductibles, though others just focus on insurance payments. Many experts recommend collecting upfront, either all or a portion of what you know will be due, as good, proactive collections practice.

Every practice needs to decide if up-front collections will work for them, but any practice, regardless of specialty, can collect before rendering services. The only exception would be if your payer contracts forbid it.

If you decide to collect co-pays and/or co-insurance and deductibles up front, put your policy in writing and educate patients about what they should expect and how the process is handled.

Heads up: If you collect for co-insurance payment up front, you’ll receive an estimated amount. There might still be a balance for the patient to cover afterward. Be sure you let patients know this as well so they are not surprised to get another bill.