Managed Care Contract Negotiations
Mar 16

Seven tips to tackle high-deductible plans

The percentage of employers offering high-deductible plans jumped from 5% in 2003 to 20% in 2005, according to industry publications. It’s reasonable to believe that the percentage will continue to rise in 2006. These plans present reimbursement challenges to your facility, so your managed care contracting professionals should learn how to revisit and rewrite contract language to ensure that the organization receives payment for its services.

Here are seven tips to prepare for the challenges of high-deductible health plans:

1. Examine your participating provider agreements with insurers, networks, and plans to ensure that you know which types of insurance products are included in the contract.

2. Negotiate contract language to exclude those enrolled in plans that may present collection problems in the future. Ask about these products in your negotiation. If an insurer includes high-deductible products, ask it how these products work. Learn what systems it has to assist you.

3. Learn in advance how to handle uncollectible deductibles without risking loss of payment from insurers.

4. Train staff to look for patients enrolled in high-deductible health plans. Give them scripts to ask about the deductible, whether a health savings account exists, and, if so, the amount of money and assets available to them to pay their bills.

5. Make sure that your policies for dealing with medical indigence and bad debt make sense for individuals who are underinsured.

6. Explore collections products and vendors to streamline your collection process and increase your collection rates. Learn from your collections vendors and second placement agencies what they need to increase their likelihood of collections, and incorporate this advice into your patient financial services best practices.

7. Track your experience with high-deductible products and other insurers. This will help you identify which plans cause collections problems.

This week’s tip was excerpted from HCPro’s monthly newsletter, Managed Care Contracting & Reimbursement Advisor. For more information, click here.

About Reed Tinsley, CPA

As a top advisor to physicians, I help increase practice profits by delivering hands-on, expert medical accounting/tax support, practice counsel, and revenue-building strategies. Read more →