Does Your Ophthalmology Practice Have an Action Plan for Collecting Deductibles?

By Michael Carroll on March 8, 2018

While the Affordable Care Act has lowered the number of uninsured Americans, the number of people using high deductible health plans (HDHPs) has significantly increased. They have insurance, but many Americans are struggling with increased out-of-pocket costs.

report from the Kaiser Family Foundation found that the average annual out-of-pocket costs per patient increased almost 230% between 2006 and 2015. What does that mean for physicians? It means drastic changes in cash flow, collections and billing.

Physicians used to collect most reimbursements from the government or commercial insurance companies. However, a study from InstaMed estimates the number of consumer payments to healthcare providers increased by 193% between 2011 and 2014. Couple those statistics with the fact that employee wages have only increased an average of 1.9% between 2014 and 2015, and it’s not surprising that many healthcare practices are struggling with uncollectible accounts.

Do you have an action plan for collecting fees from patients with HDHPs? Consider these tips.

No Surprises

Do not depend on patients to know their plan or the status of their deductible. It’s standard practice to verify insurance before an appointment. However, view your office as the insurance advocate for the patient. Find out the status of the patient’s deductible so there is no confusion. When staff call or email to confirm the appointment, give the patient as much information as possible. Don’t make financial obligation the focal point of the call. Instead, phrase it as the pre-registration process. Verify all patient information and use the opportunity to inform the patient about their deductible status and the amount that will be due. If there is an error, this gives the patient the opportunity to contact the insurance provider to clear it up before the appointment. Patients should understand the amount quoted is only an estimate. Never make patients ask for a refund. If insurance covers more than anticipated, have a plan in place to refund the patient immediately.

Including this step in your action plan does more than just increase the likelihood that you’ll get paid. It also builds the practice’s reputation with the patient as a trusted source. Patients will appreciate the assistance and will not be surprised when they are asked to make a payment on the day of service. Additionally, communicate clearly in every way possible. Post a sign in the office indicating payment is due at the time of service. Have staff remind patients when they call to schedule the appointment that payment is required. Include the information on your website, in newsletters and any other communication with the patient.

No surprises must also apply to your front desk staff. They are often the ones left to deal with a difficult patient that does not want to pay. Provide training. Ensure that all your staff are well-informed regarding office policies. Hold practice sessions, preparing staff to deal with patients respectfully. Train staff to politely ask open-ended questions, such as” How would you like to pay your bill today?” instead of “Would you like to pay?” or “Your total is…”

Many offices find it beneficial to designate an insurance expert. While all front desk staff should know the basics, the expert will know the minute details and serve as a valuable resource to the office and patients. Empower the expert to make a decision if payment can be delayed if there is a discrepancy between the patient and the information from the insurer.

Offer Options

While payment in full on the day of service is preferable, there are times when a procedure is so costly that it is just not possible. Physicians often sympathize when they know a procedure should not wait, yet the patient cannot pay at that time. Offer appropriate options. Put all payment plans in writing including payment amount, timeline and the consequences if a payment is missed. Offer an incentive to pay the amount off early. A simple 5 or 10% discount may be enough to motivate a patient to prioritize the bill. Offer automatic deductions from the patient’s checking account or a credit card. It’s common for practices to waive any interest if payments are automatically deducted each month.

Make payments easy. Accept credit cards, cash or check. For payment plans, set up online payments via your website. Send email reminders with a direct link to make a payment. Be sure online payments are mobile friendly. Pew Research Center found that 46% of U.S. consumers are making mobile payments now. That’s 114 million adults. Don’t lose collections just because a patient forgot to log into a desktop computer and pay.

Build Trust with the Patient

Patients are more likely to pay when they have a trusted relationship with a provider. Regularly communicate beneficial information not related to bill collection. For example, many HDHP participants avoid receiving care because they know they will have out-of-pocket costs. However, they may not know wellness visits and screenings may be covered by their insurance carrier at no cost. Create an informative newsletter, postcard or email with helpful tips for managing a HDHP. Patients should view the practice as “on their side”. This will make them more likely to be honest about their ability to pay and more likely to honor payment plans and other policies.

Partnering with a trusted billing company like Agnite Health LLC, an affiliate of Advantage Administration, Inc., will help your practice establish an efficient A/R process. A smooth billing process is especially critical in our evolving healthcare environment. The billing professionals at Agnite Health LLC will help you get paid as quickly as possible while also keeping a strong doctor/patient relationship. We are ready to become a seamless extension of your practice. Contact us to learn more about how our services can help your practice.