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Dermatology Coding Alert

Billing Corner:

Turn That Copayment Frown Upside Down

Published on Fri Oct 08, 2004 Print Friendly and PDF PDF

Capture your copays by revamping a few in-office protocols

Collecting copays is difficult for any dermatology practice, but you'll have better results if you work on coordinating surgery and office copays and adjust appointment calls to remind patients about copays on the front end. 

But our practice management experts provide you with suggestions to ease the pain of copayment collections.

Make a few paperwork adjustments and see the dollars rise

To improve the collection of your copayments, you can start by following a strict protocol for collecting co-pays, experts say.

Explanation: Dermatology practices often see patients who need the dermatologist to complete several procedures (such as several lesion excisions completed at one visit or debridement procedures completed on different parts of the body), which are often coupled with an E/M service.

The confusion: Collecting copays up-front becomes a challenge when the insurance card specifies a copay for surgery and another copay for office visits or a copay per procedure. For example, a patient checks in, and you know that he is here to have the dermatologist remove a skin tag (11200, Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions).

Old way: You get caught up in the hustle and bustle of checking in all of your patients and you charge the patient $20. After things calm down, you realize that the surgical co-pay according to that patient's insurance plan is $50, so you have to bill the patient for the remaining $30. At this point, he is not very happy that you made this oversight, and after a couple of weeks of talking to an answering machine, you are not happy that you have to take the time to make collection calls in addition to your other duties.

New way: If you have a patient who has two different copays on his card, you can tell the front office that if they are entering procedures with CPT codes 10000 to 60000 (surgical procedures), they need to collect $50.

Small adjustments in your appointment protocol can add up

You can also see an increase in your copayment collections if you make some changes to your appointment procedure. Here's a scenario that might shed some new light on something you are all accustomed to:

  • Patient calls to make an appointment.

  • You ask for the patient's insurance carrier, including copay requirement.

  • After you have repeated the confirmed appointment, state to the patient: "We would like our patients to know that copayments are required at time of check-in. If you cannot make payments at that time, please call us 24 hours prior to your appointment to reschedule."

    Then you can store the copayment amount in the patient's registration file so you know what to expect in future visits, says Diane Tadlock, dermatology coding specialist at the Patient Revenue Management Organization at Duke University Health System in Durham, N.C.

    Extra: You can also increase your chances of collecting copays by accepting credit cards and asking for payment when the patient checks in, says Ellen Wallpe, CPC, coding consultant in Eliot, Maine.

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