As you evaluate the year in terms of remuneration for the labs, pharmacies, and primary care you realize that growing risk you succumb due to the implementation of new regulations in medical billing. For the physicians in an effort to get reimbursed for implementing the insurance coverage in the defense of claim and satisfy the patient liability.

The bankruptcy trustee for diagnostic lab filed over 1,000 lawsuits against all physicians trying to regain the benefit of lab creditors for the excessively large specimen for processing and handling fees paid by physicians.

How to handle Co-pay and Deductible?

Collecting co-pays and deductibles is an important piece for accurately valuing the service provided in medical billing and coding. We still hear about practices that routinely waive their patient’s deductibles and co-pays. In the past collecting different deductibles and co-pays when the patient presents with federally funded insurance for Medicare but with ACA co-pays is becoming a burden. The Department of Justice stepped in to reduce the burden of waving deductibles and co-pays raising a Federal Anti-Kickback statute.

With physicians now stepping into shoes of a financial planner with payment being continuously being reduced and on other hand the cost of doing business keeps raising. It’s hard for you to manage the service without full payment here let’s take an example to understand the billing better if you are getting paid $100 per visit where the co-pay amount is $25 and payment by insurance companies is $75. Now, most of you make the mistake of waving off the remaining co-payment and the physicians practice is only paid $75.

Commercial insurance companies usually have a contract with employees or employers under new Affordable Healthcare Act for individuals. The insurance companies charge a premium for the health insurance provided, usually, the insurance companies provide a mutually agreed amount without interfering in the co-pays for both in-network and out-of-network. If the providers unilateral decide of waving off the co-pay amount then the covered person contractual financial obligation is under a threat and the insurance company or employers can sue the providers.

What can Physicians Do?

Initial Patient Policy

  1. Establish a patient procedure where the patient confirms that they are suffering from the financial hardship and document it. Make the patient sign the acknowledgment before beginning with the procedure.
  2. Make an effort to collect your deductibles and co-pays, unless the reasons are verified. Even if the patient demonstrates a financial hardship ask the patient what amount they can pay from the co-pay and deductible.

The patient’s insurance verification is one of the most important steps for you before the procedure. With channelized procedures, you can plan out your patient care. (MBC) is a medical billing company which can reduce your losses and also provides the systemized procedure of reducing the deductible loss. With over 18 years of experience and team of certified billers and coders create a revenue management system for your practice.

Published By - Medical Billers and Coders
Published Date - Jan-05-2018 Back

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