Practice Management Alert

First step: Review all payer agreements The number of patients with health savings accounts (HSAs) is increasing, and with the increase in HSA use comes an increase in confusion among billers. HSAs present collections challenges for some practices, but with a solid understanding of this consumer-driven healthcare trend and expert tips on how to work with HSA accounts, you-ll be well-prepared. Get to Know HSAs HSAs came about as part of the Medicare Modernization Act of 2003. They are personal savings accounts that provide patients with a tax-free way to save for qualified medical expenses. One component of an HSA is that it has to be linked to a high- deductible health plan (HDHP) -- a health insurance plan that has a higher annual deductible than typical health plans and a maximum limit on the annual out-of-pocket medical expenses that the employee must pay. "Health savings accounts were built as a way to start to re-engage patients and employees into some of the core costs of their health experience and expenses," says Debra Wiggs, FACMPE, of Trinity Management Solutions in Bellingham, Wash. "The federal government came up with this idea of a health savings account that is meant to be an insurance benefit vehicle." Note: "HSAs are not available in every part of the country yet, and some of that has to do with different states- employee laws," Wiggs says. The goal: The government and those supporting HSAs hope that when a patient is faced with the high deductibles, he will play a bigger part in his own health-care and medical decisions. "HSAs provide a way for the employer to provide a health insurance benefit in a way that leaves much of the responsibility for how those dollars are spent for medical services in the hands of the employee," Wiggs says. Mistake: One original idea about HSAs and HDHPs was that physicians would be able to have a price list for patients, and billers wouldn't have to submit claims to the insurance company. "That original line of thinking was always dead wrong," says Matthew Holt, author of The Health Care Blog and researcher, generalist forecaster and strategist with Matthew Holt Consulting in San Francisco. "HDHPs operate like HDHPs always have within the framework of insurance and contracted rates." You still need to follow the contract you have with the payer, not set your own prices. Overcome HSA Challenges The challenge for billers comes when they try collect-ing payments from patients who face high deductibles. Members of the American Medical Billing Association (AMBA) say that HSAs affect their practices two ways, says Cyndee Weston, executive director of the AMBA in Sulphur, Okla. "They said the problems are twofold: - They do have [...]