Practice Management Alert

With fewer patients following through on procedures because of economic and financial struggles, and an increasing number of patients not paying their bills, your practice needs to find ways to improve your A/R and bring in deserved money. Adapting an up-front deductible collection policy is one proven way to do both -- and setting up a policy can be as easy as 1-2-3.

Insurance verification services now make it possible for practices to find out if a patient has met his deductible yet. Some services can tell you how much of the deductible remains unpaid. Because this information is available online, your practice can get this information last-minute, the day of, the day before, or several days before the patient is scheduled to come in for a service or procedure.

"I have started to look up insurance deductibles and copays on Web sites," says Joy Bloodworth, CPC, CCS-P, office manager and coder for Surgical Associates in Cordele, Ga.

Pointer: Check with your benefits verification services, as some offer real-time information on how much of a patient's benefits have been used to date, the deductible to date remaining, number of hospital days remaining, skilled nursing facility (SNF) days remaining, and if the patient has Medigap coverage that will cover a portion of the payment.

Once you have the information from the payer about what the patient's responsibility will be, you should contact the patient. Most practices are more successful when they contact the patient several days before the procedure, rather than the day of the procedure, experts say.

"We are calling patients about one to two weeks in advance if possible requesting the deductible or their percentage of the allowable of their insurance for the procedure being performed," says Lori Owens, CPC, CGIC, insurance supervisor at Ohio Valley Surgical Specialists in Owensboro, Ky. "It is working fairly well."

Be clear: Make sure you tell the patient where you got the information about her deductible and let her know that the amount is an estimate based on the services your physician expects to perform, Bloodworth cautions. Otherwise, you may get calls from patients after procedures "saying they paid up front and don't owe any more after the insurance pays," she says. "When I get the information from the insurance company, I tell the patient it is just an estimate and after insurance pays we will adjust the payment form accordingly."

If you cannot collect up front from a patient, you're left with two options: Cancel the procedure or perform the procedure and hope the patient pays you afterwards when you send a bill.

"If there's no emergency, we ask that the patient pay the copay and deductible up front," Bloodworth. "We will reschedule if the patient does not have it and the physician says it is elective."

Some patients may get upset that you're asking for their money before you perform a service, especially if they don't feel they can pay their deductible. "We feel that these patients would probably not pay anyway and it makes room for patients waiting to have procedures performed," Owens explains.

Other patients, however, may simply need additional time to pay you. Even when you don't collect up front, making an attempt can still help you collect eventually. A patient will know before having the procedure exactly how much she will owe your practice.

"You may not collect from all," Owens says. If her practice doesn't cancel the procedure, the call "just lets the patient know how much to expect" when the practicesends a bill.

Set up a payment plan: Some patients cannot come up with the entire deductible amount up front and will ask to make payments, Bloodworth explains. "They have to come up with at least half of it and sign a form showing the balance due and payments less than $200 will be paid by three months and over $200 will be paid by six months."

Bottom line: At least attempting to collect deductibles up front is beneficial for your practice. "Our A/R is more in line now and we definitely have seen a difference," Owens says. "It is worth the hassle."