The Weekly RUSH - High Stakes

Patient Preparation = Prompt Payment

Deductibles and coinsurance payments are at all time highs. Maybe you’ve caught an earful from a patient when they found out their portion of the bill. Many with high deductible plans cannot afford to pay their portion and in some cases, elect to forgo services. Fortunately, you’re in a position to help! Informing patients of financial liability even two days in advance of service can give them time to withdraw money from savings or make other arrangements.

Challenge: Calculating a patient’s portion can be trickier than it looks - even when you have all the patient’s personal and policy information. And now, insurers are getting more creative about how they pay benefits. Limits, first dollar coverage and additional co-pays have added to the calculation’s complexity. Is there a solid way to calculate the patient’s portion of payment?

Bottom-line: Frankly, there isn’t one easy answer. If the payer contract is loaded, most patient accounting systems calculate the total expected payment. However, few, if any, calculate the patient’s portion. Some providers use Excel formulas as “calculators” while others use workbooks to guide staff. Calculators and workbooks are useful tools to help staff explain to patients their payment portion. Informed patients are more engaged in their care and accountable for paying the right amount.

Bang for the Buck: The fastest growing industry within healthcare is denial management (the recovery of underpaid accounts) which makes the value of loading contracts pretty clear. Invest the time on the front end and you will save time and money on revenue collection.

Need help loading your contracts or creating a reimbursement calculator? Just give us a call.

RUSH U
Preparing the Patient to Pay – An interactive web-based course that trains staff to calculate insurance reimbursements and patient liability and how to inform patients of the amount due for services.