High-deductible health plans appeared after legislation was passed in 2003 that required persons opening a health savings account to enroll in a high-deductible plan. They gained prominence recently as employers watched their own healthcare spending skyrocket.
And in 2013, the U.S. Department of Health and Human Services reported that healthcare spending had grown at a record low pace from 2009 to 2011.
However, in this new HSA environment, practices need to think more like a business.
Because a large portion of the medical bill has traditionally been paid by commercial insurers, Medicare, and other third-party payers, many practices simply aren’t set up to collect copayments from patients efficiently (Direct Care docs, fear not, we’ve developed Atlas.md EMR so collecting payments is easy).
“Many small practices, for example, still don’t accept credit cards or have an online payment system,” says Mark Bogen, chief financial officer and senior vice president of finance at South Nassau Communities Hospital in New York.
Even worse, when the patient tells the practice he or she will pay next time, practices aren’t following up to ensure the patient actually does pay.
We’re aware of this human tendency. That’s why we’ve developed an affordable subscription model. By paying a small amount monthly (and, generally, by credit card with an auto-payment similar to Netflix or Amazon Prime), patients gain access to tremendously valued services — a doctor when they need one, prescriptions for pennies per pill…
Many physicians don’t want to discuss payments out of concern patients will think it’s all about the money, says Bogen. And, yes, that’s true. But it’s also true in almost all business discourse. Everything’s gravy until the conversation turns to compensation.
“Physicians can still offer some flexibility while maintaining the attitude that they are entitled to be paid for services rendered,” he says.
In fact, many studies have found that practices are more likely to be paid if they collect before or at the time of service. Again, the Direct Care subscription model is in alignment with this principle.
“Practices need to establish policies for how the patient will be refunded for an overpayment,” says Laura Palmer, FACMPE, senior industry analyst for the Medical Group Management Association.
A practice’s billing policy should also include a process addressing the situation of patients who have trouble paying, and a menu of options that can be presented to the patient. Options may include community programs that assist with medical bills. Of course, options may vary depending on the patient’s circumstances, which the practice should make every effort to understand, she says.
Obviously, Direct Care is a business. We can’t give away freebies. However, we are a free market enterprise, and not a conduit for government funding. Meaning, WE have the power to negotiate, bargain, etc.
There’s a difference between someone who is refusing to pay and someone who simply cannot.
Remember: The Direct Care fight is a fight for achievement. There shouldn’t be winners and losers. Ideally, the goal is to provide as much care as possible, while maximizing income.
And that income maximization comes from cutting the red tape. It doesn’t come from charging such high rates that patients find it difficult to continue their enrollment.
But, in the event that patients cannot pay, your practice’s policy should detail who in the practice will talk to overdue patients. It should also note where that discussion will take place. Conversations about overdue bills or a patient’s inability to pay should never take place at the front desk. The conversation needs to be held in private.
And, if all other efforts to collect from the patient have been exhausted, Direct Care docs can terminate their relationship with them. But that option should be reserved as an absolute last resort, and it must be handled delicately. Patients should be given ample warning, and they must be referred to another care provider.
Read the complete article on the Medical Economics website.