Dealing with patients ’ health insurers is often complex and frustrating for physicians and their practice staff. Navigating the maze of health insurer contracts and contending with medical payment and other reimbursement rules that differ from health insurer to health insurer demands significant administrative cost and time. After investing in expensive practice management systems and submitting claims to patients ’ health insurers, physicians and their practice staff find that it can take weeks or even months to receive payment from these health insurers—if they receive payment at all. Health insurers also often change contracted rates with little or no notice, which makes it difficult to audit payments for accuracy. On top of all this, many physicians have been unable to negotiate rates that are adequate to cover increasing practice costs, leaving them with the feeling that maintaining the financial viability of their practices is beyond their control.
Physicians seeking ways to simplify their practices and reduce administrative overhead are evaluating whether limiting their financial dependence on health insurer contracts is a viable option. So providers are try to get the more payment from patients but this process is more complicated and will cost more than billing insurance. Here is the best method to overcome both of these method.
Time-of-service collections
Without changing your health insurer contracts or making dramatic changes in your practice administration, you can collect most copayments, coinsurance and deductibles from patients at the time of service. This approach avoids the payment delays that result when you wait for the health insurer explanation of benefits (EOB) and bill your patient weeks or even months after his or her appointment.
Implementing time-of-service collections allows you to:
* Receive your payment of the patient ’ s financial responsibility immediately
* Lower administrative costs by eliminating the need to bill patients or pursue collection, except in special circumstances
*Improve patient service by providing cost information in advance or at the time of service
*Quickly identify patients who are reluctant or unable to pay so you can address their situations proactively and professionally and avoid months of billing expense and aggravation
You shouldn ’ t need to make significant changes to your practice in order to collect at the time of service. You can continue to use your practice management system for billing Medicare, health insurers and certain patients who cannot or will not pay their share at the time of service, or for whom you waive the time-of-service payment policy. The number of practice staff you need will probably not change. If you use a billing service, however, this is an opportunity to renegotiate your service contract if the billing service ’ s workload decreases as a result of reduced patient billing and collection follow-up.
If you are an office-based physician practice and you want to collect the patient financial responsibility at the time of service, the following are some key components for successfully implementing this change:
1. Develop a written financial policy for patients to read and sign.
2. Deliver clear instructions to your practice staff, informing them that collecting from patients is part of the check- in and check-out process. Make sure that your practice staff communicates with patients about their financial responsibility openly and matter-of-factly.
3. Ensure your practice staff uses the electronic eligibility response information coupled with practice management system tools to calculate the cost of services according to the patient ’ s health insurance coverage and appropriate copayments, coinsurance and deductibles.
4. Accept the full range of payment methods, including credit cards, debit cards and electronic checks. For expensive procedures, you may want to consider offering third-party credit, which pays you directly by lending to the patient— you may wish to check with your bank for suggestions.
5. Review your contracts to see if any of them prohibit you from collecting co-insurance or deductibles at the time of service. You may wish to consider negotiating an exemption for your practice, especially if you have successfully implemented a time-of-service collection process for patients covered by health insurers that do not impose such a limitation.
