In the last few years, more and more individuals are opting for ‘High Deductible Health Plan (HDHP)’. High deductible plans offer several benefits like lower monthly premiums, tax-advantage, and it allows using HSA in conjunction with an HDHP. But more patients with high deductible plans could be a cause of worry for any practice owner. For years 2021 and 2022, the IRS (Internal Revenue Service) defines an HDHP as one with a deductible of at least $1,400 for individuals and $2,800 for families. The maximum deductible for 2021 is $7,000 for an individual and $14,00 for a family. These limits increase to $7,050 and $14,100 in 2022. Due to high deductible plans, things are rapidly changing, the traditional question for patients is changing from ‘Do you have insurance?’ to ‘What kind of insurance do you have?’ With high deductibles, you need rigorous collection efforts and a sound strategy in handling all these patients with high deductible plans.
A recent research report from the Rand Corporation suggests that high deductible plans prevent some patients from seeking preventive care. Even though you already counsel patients on wellness and prevention, you may need to really emphasize the importance of regular screenings and annual exams. Point out that many of these plans cover preventive services regardless of the deductible, including cancer screenings, diabetes testing, and childhood immunizations. If you’re experiencing a higher number than usual of appointment cancellations, check your practice data to find out if a high percentage carries high-deductible plans. If this is the case, emphasize the importance of regular health monitoring when you send out appointment reminders.
Train your staff on answering questions about pricing your services over the telephone and in person. In the era of consumer-driven healthcare, more patients will be ‘browsing around’ based on price. And when they’re in your exam room, patients are more likely to ask for a comparison of charges if you recommend different diagnostic or treatment options. If possible, give a detailed price estimation for any inquiry, and explain in detail.
When patients ask how much a service will cost and agree to go forward, it’s a perfect opportunity for your staff to ask how they’d like to pay for their responsibility. Collecting upfront will also save you from sending patient statements and collection reminders. It can also help keep your medical group revenue strong. Eligibility and benefits verification reports could tell you exact patient responsibility in advance and patient’s coverage for various medical services. Note that any patient outstanding more than 120 days, is less likely to get recovered. Efforts you and your staff are putting in will cost you more than the outstanding amount. Set up an aim to collect more than 90 percent at the time of visit, also find out reasons why this target can’t be achieved.
As per our observation, self-pay patients and high-deductible plan patients always look for a negotiated fee. Generally, you have more freedom on what to charge cash-paying patients. In contrast, most insurance contracts state physicians must charge a negotiated rate for services. Some insured patients might even present themselves as uninsured to pay less. Decide in advance how and when you want to offer a payment plan to patients if they ask.
All the above-mentioned tips require you to have well-trained medical billing experts. But most of the practice owners are facing high employee turnover and increased manpower cost due to payroll, employment benefits, and continuous training expenses. Connecting with medical billing company ‘MedicalBillersandCoders (MBC)’ will ensure you will receive eligibility and benefits reports in advance, patients are communicated with accurate cost estimation, and prior authorization will be completed. So, when patients visit your office, you just have to collect patient responsibility as per the report. Your collection percentage will also be higher as all patients are well informed about cost estimation and modes of payment well before the actual visit.