Practice Management Alert

Save time, effort by learning the downsides of up-front collection. Collecting deductibles from patients has never been more difficult -- between determining whether the patient has secondary coverage and seeking answers on whether she's already met her deductible, you could lose an hour of your time. Payer confusion and differing rules only add more difficulty to the process -- and more headaches to your day. But if you follow these expert answers to two of the top questions about collecting deductibles, you can deter-mine if up-front collections are right for your office. Here's how. Question 1: When Can I Collect the Deductible? One of your payers tells you that you are performing an illegal act by collecting a deductible from a patient before you receive an EOB from the insurer. Is the payer correct in this statement? No, says Joan Gilhooly, CPC, CHCC, president of Medical Business Resources, LLC. Compliance answer: "From a compliance standpoint, if the practice knew without a doubt that the patient's deductible had not been met, there is nothing that prohibits the practice from collecting it at the time of service prior to sending the claim to Medicare," Gilhooly says. Good business sense: Even though it's legal to collect a patient's deductible at the time of service, it may not be a good business practice. "In the distant past, people may not have had secondary payers, and it may have made good sense to collect the deductible in January," Gilhooly says. "But now that Medicare pays so promptly and so many people have secondary plans, it's very uncommon to find someone whose deductible you need to collect up front." Secondary payers will usually pay you the cost of the patient's deductible, and the secondary payment often arrives at your office before you even receive your Part B reimbursement, Gilhooly says. Information available: Insurance verification services now make it possible for practices to find out if a patient has met his deductible yet. Some services actually 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 before, or the day of the appointment. Question 2: Can't We Just Issue a Refund If Needed? "Some practices collect the deductible up front as a rule, especially if they see the patient early in January and then figure they-ll just issue a refund later if necessary," says Jay Neal, a coding consultant in Atlanta. "But generating all of those refunds can be a headache when February rolls around," Neal adds. This practice can also be costly for your practice. The cost: What you collect from the patient up front probably isn't as much as you-d spend processing [...]