Wiki CHARGING UP FRONT FOR DEDUCTIBLE ?

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CodingMari

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I work in the state of Pennsylvania. Could someone shed some light into charging a minimum upfront for patients that have a deductible? We have been seeing a lot of claims processed, and insurance is leaving about $80 or more for patients. However, they don't pay this. They continue coming to our practice, but don't pay anything. There are patients with a balance of over $1000.00 who get a statement but won't pay anything. Then they come back with new insurance and this balance is just being written off to bad debt.
 
Sounds like you have a major revenue cycle problem there. I am always in shock when I go to a medical provider or practice and they don't ask me for any money at the front desk. After working in this field for 20+ years, and having managed a rev cycle, I know I have a high deductible health plan, I try to give them money, and they still won't take it sometimes. It is astounding. At one front desk they actually said, "We are not set up to take any money at the desk." WHAT!? :oops: Depending on the type of practice you are talking about, there could be some nuances to it. You must collect something...anything... at the time of service. It is best to collect the full amount, set up a card on file, have Care Credit available, payment plans, anything. If your practice has nothing at all it sounds like you need possibly outside help or some system and policies and procedures to be set up. Practices should have a system where the benefits are checked before the appointment so you know the patient's responsibility (they know too btw.) Of course, if you don't get the $ up front, they are going to be seen and many do not pay. Why is the practice continuing to see them if they have a huge balance?

There's definitely an art to it, the front desk is a tough place to work. Folks working the front desk and even at the appointment scheduling level need training and education. They are the front line for patient collections. They can't be afraid to ask for payment.

If there is no system or policies, this needs to come from the top down. And, a practice attorney, CFO, CEO, compliance, etc. needs to be involved to make sure state law is being followed when it comes to medical debt and medical collections.

 
I would just add that it is possible and allowable to stop treating patients who don't pay and won't make arrangements to pay, but you have to do it by the books to avoid accusations of abandonment, HIPAA violations, etc.

Also, I don't know Medicaid rules, but with Medicare not collecting from the patient can create a separate set of compliance issues.
 
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