It is essential that physicians educate patients about their payment responsibilities!
Patient payment responsibilities have grown at an exponential rate over the years. Out have pocket expenses have increased for patients and as a result, a drastic shift is going on at the healthcare space. From being written off most of the time and being just a small tributary in the revenue stream, patient payment now compromises of a huge chunk of a practice’s revenue.
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Patient education can improve collections!
Most patients are in for sticker shock when handed over their bills. It leads to a long-drawn and painful process of collecting outstanding patient bills. To shorten the path to patient physicians will have to educate patients.
A survey by TransUnion Healthcare of more than 700 insured consumer reports
- 75% of patients said that a pre-treatment estimates of out-of-pocket costs would improve their ability to pay for healthcare
- Nearly six in 10 patients (56%) either rarely or never received an estimate of out-of-pocket costs before they received treatment
- 59% said they have been surprised by the costs they were responsible for when receiving their final bill.
What the experts say?
These healthcare experts represent the two camps (provider and payer) at war over educating patients about their deductibles
Peg Graham, of Yana Health Forum, opines that informing patients about their payment responsibilities, ahead of time can give patients the choice of opting for a treatment or not. And that it could also help providers to suggest possible health plans that better suit the patient’s needs.
This is a view echoed byLaurie Morgan Senior consultant and partner of Capko & Morgan. “If practices don’t take responsibility, they risk subjecting the patient to a very unpleasant surprise bill. And that, in turn, reduces the practice’s likelihood of getting paid. It would be great if health plans did a better job of explaining their terms. But knowing that plans are complicated and patients often don’t understand them means that there is a burden on practices to educate patients — or risk the consequences“, she warns.
While Liz Skirving an Executive Director at Pucillo Family Practice counters the above views and says “it’s hard for the small practices with less number of staff and time to educate the patients about deductibles. The patients should call the insurance company and find out themselves”. Liz adds that they do verify patients insurance and deductibles before and quotes “we provide medical services, not financial services”.
“Patient education should begin with the pre-appointment process and continue throughout the revenue life-cycle. By gathering patient’s information ahead of time, and continually monitoring their insurance coverage/benefits through the entire process will result in a much improved reimbursement for services rendered” said Jose O. Suarez Healthcare Entrepreneur.
Denice Nolan an office manager at Ankle & Foot Clinic says educating patients has been very profitable in terms of reduced patient billings “You do have to be careful with deductibles and have knowledgeable staff to ask the right questions as to not overlap other providers claims” she feels.
Patients should be educated on the requirements as dictated by their insurance carrier says Wendy Williamson owner at The Williamson Group, LLC and quotes “Focus of visit should be on what is necessary to get the patient to a place of well being. Insurance requirements should be disclosed and discussed by the insurance carrier prior to a visit, so the patient is not alarmed when they receive a bill and/or the patient can make sure they are making a visit with a provider that either in network and/or they understand the financial impact should they opt for an OON provider”.
The only down side is that carriers quote the benefit without understanding the benefit. “A huge issue is Mediblue, patients do not understand that their co-pay just for walking in the door and by the time they exit, their co-pay can be as much as $105 a visit( for an ENT speciality).Patients do not understand their policies, bottom line” said Lori Lebowitz a medical billing manager.
The healthcare experts agree that providers and payers join hands and educate patients to help them make informed decisions. The blame game of, its not me it’s him, is never going to stop. The payer isn’t going to do it all and the provider is going to have a tough time educating patients on their payments. Small practices with less number of staff who wear at least two hats or sometimes more can’t afford to spend a lot of time following up with patients.
A better option…
There is nobody else who understands the revenue cycle of a medical practice better than its billing team or collection house. Handing over the responsibility of handling patient billing to medical billers could well be the best solution for medical practices.
