Collecting Patient Deductibles in a Medical Practice
Medical Practice Management
Feb 04

Collecting Patient Deductibles in a Medical Practice

Patient Deductibles in a Medical Practice

It’s that time of year again – patients will make an appointment with you and they will now have a copayment “and” a deductible to pay. As patient deductibles increase each year, deductibles can be a significant part of your medical practice cash pay revenue. As such, it is important to have timely and proper collection. All medical practices must be organized in their approach in collecting deductibles as well as have clear policies to educate their patient population. To begin, follow these:

Simple Steps

Insurance verification

Do not leave it up to the patient to inform you if their deductible has been met – use some of the latest software that provides you with real time insurance verification information. Remember, verify insurance at least 48 to 72 hours prior to the visit to give you time to address any possible issues with the patient that may arise before they arrive.

Collect the deductible up front

Along with insurance verification software, there are other online software products that will allow you to estimate the cost of the procedure, or service being rendered, and how much the patient would have to come out of pocket in the form of deductible to the practice. I like to call these EOB estimates. Let the patient know that the deductible is expected to be paid prior to any service or procedure unless it is an emergency and in that case payment plans can be worked out.

Give time for payment

If the procedure or service is planned months in advance as seen with obstetric cases or major non-emergency surgery – it is valid to give the patient a payment plan so they have the opportunity to pay the entire deductible over time prior to the procedure – this takes some of the financial burden off of the patient (which they will appreciate) and also ensures your practice has collected all monies due to you.

Educate the patient

Be sure to educate the patient that the deductible is expected up front, explain to the patient it is part of their contract with the insurance company to meet out of pocket minimums – however create a policy that assures the patient that if the practice receives an EOB which shows the patient has overpaid, or no deductible was indeed required for that particular procedure or service, that a refund will be issued to them within 7 to 10 business days of receiving the notice. Be sure this rule is clearly stated in your financial policy that should be given to all patients when they join the practice, and when there have been changes.

Time is money

Hopefully the four steps above will help assuage your fear of collecting deductibles up front and enable you to create a policy that not only ensures the financial health of your medical practice, but help your patients as well through the process. Remember, it is always easier to get your money as the patient is walking in the door, rather than chasing the dollar after they leave – in the end the chase will cost you more money and decrease your overall revenue – it all boils down to the time value of money.

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 →