Patients with high-deductible insurance plans may be shocked when they receive a large bill from the practice, because often they don’t understand their plans, says Hertz. This leaves physicians in the position of arguing with patients who have just been handed a bill for $750, and they just keep saying, “but I have insurance, they’ll pay it.”
Gundling says establishing solid financial processes and training staff on them is key to getting paid, and it starts with the registration process. Before a patient comes in, the staff should know their coverage and where they are with their deductible and that should be shared with the patient prior to treatment. They should also be able to explain insurance terminology and plan details. “You are more likely to get paid if the patient knows you’ve checked the insurance and you have their best financial interest at heart as well as their best clinical interest.”
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Nick Beechnau agrees that patient education plays a big role in getting paid. “They think the bill is only for a few dollars, so what’s the big deal? But when they understand the hours it takes to put the letter together and the money spent to collect [the bill], they are more likely to pay.”
By having conversations while also offering financing options, patients see that the practice is trying to help them, says Gundling. This empathy from practice employees also can affect patient satisfaction scores, which are becoming increasingly important for reimbursement under value-based care.
“A patient that needs financial guidance sees [financial help] as part of the total quality they are getting from the practice,” Gundling says. “Patients may not always understand all the medical terminology, insurance terms or financial terms, but how the practice handles it is all part of quality.”
The early months of the year will continue to be a financial struggle as high-deductible plans proliferate and slow the cash coming into practices, but it doesn’t have to be an issue if the practice is prepared.
“If you embrace a creative approach and work with the people who have to pay you, I think they benefit and you benefit,” Hertz says. “If you take a hard line, you will get people who are unhappy and stressed and end up with balances that are not collected. If you work together, it’s a win for everyone.”