The Part B Medicare deductible for 2013 is $147.00.
What should you do with this information? You should avoid taking a big financial hit in the first quarter of 2013 by collecting deductibles at time of service. How do you do that?
Let all patients know in advance that you collect deductibles by making it part of your communication with them. Put it in your financial policy (get a copy of my preferred financial policy below), put it on your website, and let patients know when you schedule their appointment, or make an appointment reminder with verbiage like:
“We look forward to seeing you at your appointment. Please bring your insurance cards and all medications to your visit. We will collect your co-pay, your deductible, and any co-insurance required by your insurance plan.”
Explain what a deductible is. Get my sample patient handout explaining deductibles below.
Train front desk staff on deductibles and get them comfortable discussing deductibles with patients and answering their questions.
Do not collect deductibles for Medicare patients who also have Medicaid, or for Medicare patients with supplemental insurance as there most likely will not be a balance that the patient will owe.
It is ideal to use a Credit Card On File program to charge the patient’s credit card at time of service, or when the EOB (Explanation of Benefits) arrives in 15 days.
In Part 1 of this series we explored payers. Now it’s time to develop your financial policy. This is your foundational document for everything that happens with patient financial interactions. Your financial policy will confirm for patients and staff what your practice financial policies are, and will support the financial goals of the practice.
The road to financial health
Putting together a new financial policy or revising your existing policy is one of the most important steps to financial health. Your financial policy is your road map and will determine how the practice will handle the collection of patient balances. The financial policy is the document you will come back to time and time again. If a question arises, ask yourself, “What does our Financial Policy say?”
In a traditional healthcare setting, the revenue cycle begins with the insurance companies who pay the majority of the bill. There are multitudes of payers and each payer can have many plans. How can a healthcare organization catalog this information, keep this information updated and make this information easily accessible to staff so they can discuss payments with patients in an informed and confident way?
Start by breaking your payers into five main categories as a logical way to organize the data.
Payers with whom you have a contract
Payers with whom you do not have a contract
State and Federal government payers (Medicare, Medicaid, TriCare)
Medicare Advantage payers
Payers with whom you have a contract
Your organization has signed a contract with a payer and you have agreed to accept a discounted fee called an allowable, and to abide by their rules. What is the information you need to collect?
A copy of the contract
A detailed fee schedule, or a basis for the fees, such as “150% of the 2008 Medicare fee schedule.”
Any information about the fees being increased periodically based on economic indicators, or rules (notification, timeline, appeals) on how the payer can change the fee schedule.
The process and a contact name for appealing incorrect payments.
Information on what can be collected at time of service. Hopefully your contract does not have any language that prohibits collections at time of service, but you must know what the contract states.
Process for checking on patients’ eligibility and benefits: representative by phone, interactive voice response (IVR), website or third-party access.