FIVE WAYS TO HANDLE HIGH-DEDUCTIBLE PATIENTS IN YOUR MEDICAL PRACTICE

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1 Billing & Reimbursement Revenue Cycle Management FIVE WAYS TO HANDLE HIGH-DEDUCTIBLE PATIENTS IN YOUR MEDICAL PRACTICE Billing and Reimbursement for Physician Offices, Ambulatory Surgery Centers and Hospitals Billings & Reimbursements Revenue Cycle Management

2 Five Ways to Handle High-Deductible Patients in Your Medical Practice Contents High-deductible patients are likely to comparison shop before choosing a healthcare provider. 4 Emphasize the importance of preventive healthcare 5 Educate patients 6 Tell patients up front what services will cost 6 Collect copays or co-insurance at the visit 7 Offer discounts and payment plans 2

3 Five Ways to Handle High-Deductible Patients in Your Medical Practice In 2014, 37 percent of adults under age 65 had high-deductible health insurance plans. When patients bear a greater financial responsibility for their medical care, they may visit their doctor less often. There are several steps you can take to encourage these high-deductible patients to visit your practice for regular health care. Power Your Practice recommends these five strategies for handling high-deductible patients: 3

4 Emphasize the importance of preventive healthcare. High-deductible patients may not seek preventive care, fearing the costs involved. Emphasize the importance of annual checkups, regular screening procedures and immunizations. Early detection of hypertension, cancer or other medical conditions may save the patient s life as well as their money. Many health plans cover preventive services, including cancer screenings, diabetes testing and childhood immunizations, without having to meet the deductible. Tell your patients what preventive services their plan covers. If most of your cancelations are by your high-deductible patients, stress the importance of regular checkups when you confirm appointments. 4

5 Educate patients. Include your payment policies (e.g., copays are required at the time of service) in your new patient paperwork to help patients understand their financial responsibility. Consider including a glossary of health insurance terms (copay, co-insurance, deductible, provider network) in your orientation packet. Refer patients to reputable sites for information about their high-deductible insurance plan. You could include these or similar resources on your website or patient portal: Fairhealthconsumer.org: Understanding High-Deductible Health Plans MVP Healthcare s video explains the difference between a deductible, copay and co-insurance. Forbes article: Should I Choose a High or Low Deductible Health Insurance Plan? 5

6 Tell patients up front what services will cost. Be as transparent as possible about your pricing. High-deductible patients are likely to comparison shop before choosing a healthcare provider. Train your staff how to answer questions about your prices on the phone or in person. Discuss your payment policies (collecting copays or co-insurance at the office visit) so people know what to expect. Be ready to compare the relative costs when discussing diagnostic or treatment options. Collect copays or co-insurance at the visit. You re more likely to collect what the patient owes at the point of service than after the fact. Instead of asking, Would you like to pay today? say, You have a $25 copay. How would you like to pay today? Online cost estimators, provided for free by payers, tell you how much the patient owes at the visit. Enter Current Procedural Terminology (CPT) codes for the office visit to find out exactly how much the staff can expect to collect from the patient. 6

7 Offer discounts and payment plans. Self-pay and high-deductible patients may ask you for a negotiated, discounted rate. In contrast to insurance contracts that require physicians to charge a negotiated fee, you have more flexibility when dealing with patients who are paying cash. Tell patients what the insurance rate would be, and then offer them a discount if they pay in full at the time of service. Train your staff how to set up payment plans. Specify the minimum payment due at the time of service (but no less than $25) and maximum timeframe for total payment (not to exceed six months). Then empower your employees to create and implement customized payment plans when needed. 7

8 About MediGain MediGain is a full-service revenue cycle management and healthcare analytics company devoted to improving billing and reimbursement for healthcare providers across the United States. MediGain provides a full suite of billing, reimbursement, credentialing and coding services to physician groups, provider networks, ambulatory surgery centers and hospitals. In addition, MediGain has industry leading proprietary business intelligence and predictive analytics that help their clients run the business of their practice. For more information on how MediGain can maximize revenue, reduce expenses and allow you to spend more time providing your patients with quality healthcare, visit our website, com; call us at or marketing@medigain.com Dallas Parkway, #200 Plano, Texas