Practice Management Alert

3 strategies will decrease patient complaints about an unexpected bill

Whether your billing office collects deductibles up front or waits until after payers process the claims, experts agree that patient education is the key to collecting what you deserve.
 
Practices that don't properly inform their patients about deductibles and billing procedures may have a lot of angry patients, says Steven Verno, NREMTP, CMBSI, director of reimbursement for Emergency Medicine Specialists in Hollywood, Fla.
 
"Education is the key," agrees Karen Deardurff, insurance specialist for Otorhinolaryngology Inc. in South Bend, Ind. "If you can educate the patient up front" about his deductible and potential expenses, you will encounter much less resistance later on when you send the bill, she says.
 
You can improve your deductible collection rate and reduce patient complaints by implementing the patient education strategies below.

 1. Create a financial policy that every new patient can read and sign. The policy should outline all of your billing and collection procedures and should specifically address your procedures on collecting deductibles, Verno says. For example, your policy might state that your office will verify deductibles with the insurance company and bill the patient accordingly after the payer has processed the claim. You should give each new patient a copy of your financial policy for his records and keep a copy signed by the patient in his medical chart.
 
Although many practices decide how to collect deductibles on a patient-by-patient basis, having a written financial policy to refer to every time is definitely a good idea, Deardurff says. There may be circumstances that require you to handle a patient's deductible differently than your plan dictates, but an established standard procedure is still good to have.

 2. Verify benefits and check deductibles over the phone when a patient calls to make an appointment. This is the best and easiest time to start collecting the patient's insurance information and educating the patient about payment obligations.
 
When a patient calls to schedule an appointment, first ask how she plans to pay for the visit, Verno advises. If the patient has insurance, request the name of her primary insurance carrier, the policy number, and the name of the policy holder. Next ask the patient to hold on while you verify her insurance information.
 
Checking a patient's insurance data should take only 30 seconds if you are able to access it over the Internet, Verno says. You should also inform the patient of any co-pay she will owe for the visit.
 
Note: If you are unable to verify a patient's insurance information online while the patient is on the phone, be sure to verify coverage by calling the insurance carrier before the patient comes to the office.

 3. Designate someone in your office as a financial planner who reviews financial information, insurance coverage, and deductibles with every new patient, Verno says. The financial planner should also review coverage and deductibles with patients about to have a costly procedure or other service, Deardurff adds.
 
A perfect time to discuss financial matters is when the patient is waiting for the physician to see her, after she has filled out the initial paperwork. The financial planner should ask the patient to come and sit down in a private office to discuss your financial policy and her insurance coverage. The dialogue between your financial planner and a new patient may go something like this:
 
Financial planner: "I just want to go over a few things before you see the doctor today to make sure you understand our payment policy. Here's a copy of our financial policy. Please take a few minutes to read and sign it. I understand that you have Aetna insurance?"
 
Patient: "Yes, that's correct."
 
Financial planner: "I'm going to call Aetna to verify what services your insurance covers and if you've met all of your deductibles. We like to do this so you know what to expect in your bill."
 
While the patient reads the financial policy, the financial planner should call the carrier to verify covered services, the effective policy date, and any deductibles and co-pays the patient needs to meet. Once the patient has signed the financial policy, your dialogue might continue like this:
 
Financial planner: "OK, I've verified your insurance coverage, and everything looks good. As we discussed when you scheduled your appointment, you have a $20 co-pay today that is payable before you see the doctor. How would you like to pay for that?"
 
Patient: "I'll pay with cash if that's all right."
 
Financial planner: "That will be great. Now you also have $50 out of your $200 deductible that you haven't met yet. We can't be sure if there are other claims in the system that your insurance carrier may apply to your deductible, so what we'll do is submit your claim and bill you for the deductible once we've heard back from your insurer. You do have to meet that deductible, and I want to tell you about it now so you won't be confused or surprised if you receive a bill from us in the mail."