One of the biggest changes in the healthcare system recently has been the growth of consumer-directed health plans (CDHP), a trend which has led to greater patient responsibility for the cost of their care.
According to a June 2014 survey from the National Business Group on Health, a nonprofit association of large U.S. employers, 57% of employers are implementing or expanding CDHPs. The percentage of employers offering only CDHPs continues to grow as well. In 2015, 32% of employers surveyed plan to have CDHPs as their only offering, up from 22% in 2014. With this shift, practices have to anticipate that a substantial portion of their income is no longer coming from an insurer.
Without processes in place to collect payment for services during a patient’s visit, some physician practices may find themselves struggling to collect from patients in full, or even at all. Cash flow can be especially low in the first and second quarters of the year, as patients have not yet met their deductible and many patients have 100% responsibility for their healthcare costs until they do. According to a September 2014 report from the Kaiser Family Foundation, the average general annual deductible for a single person enrolled in a high-deductible plan is more than $2,200 and $4,000 or more for families.
No physician or practice manager is alone in this struggle. According to a healthcare patient payment trend report from JP Morgan, practice managers have been focused on clinical applications such as electronic health records and scheduling rather than revenue cycle management and payment processing solutions. While their attention has been diverted, their bad debt has skyrocketed.
If you’re one of the independent practices —especially those with fewer than 10 staff members—dealing with this issue, here are three simple tips to implement in your practice today.
Detailed eligibility verification is a must
While for some it is standard practice to verify a patient’s insurance status either at or prior to an appointment, due to increased workloads and complications with obtaining benefit information, some practices are skipping this important step.
Not knowing if a patient is covered can be costly. And don’t stop at just confirming if the patient has coverage. Find out if the patient has a deductible and if it has been met. If you are able to ascertain the deductible balance, even better, because depending on your services, a patient may hit his or her deductible mid-visit.
Your staff should also gather information on benefit details tied to the services you offer and confirm if you are in-network for the patient. The more information you have, the more you can prepare your patients for what their responsibility likely will be.