Wiki Deductibles

[alk@APS]

Can we collect a Medicare deductible prior to the patient being seen? If no could you provide a reference? I read the Claims Processing Manual and it didn't jump out at me. Thanks

 

[carolhodge]

My question about this type of practice has always been how do you know beforehand what level of exam, medical decision making the physician is going to do?

 

[JCaillouet]

Could be wrong here but..

..who handles verifications? who makes certain patient benefits have been reviewed before time of service? If you're a Provider Office, is there a sign which states Deductible and Copay are patient responsibility and advising patients that (especially for the new year) they may be responsible for the complete visit?

You can ask. Sure. But are there policies in place to 'collect' at TOS? Are your front office staff and provider made aware of the importance of such?

Hospitals have their own protocol for this but I think it's something similar, honestly.

And for those who ask how do you know what the provider is going to do, exam wise?

Example:

Medicare - $132 deductible (I don't know, ballparking)
Account flagged
Appointment rescheduling - popup to notify patient hasn't paid deductible. Patient informed.
A/R department, after claim applied to deductible - Letter sent with line as per communication with our front office staff on xx/xx/xxxx you were advised this visit may be applied to your deductible. Your insurance, on xx/xx/xxxx has applied this visit to your deductible