Maintaining a profitable revenue stream and keeping down your accounts receivable can be a frustrating without a strong system of how to efficiently handle patients who pay for their own medical care. Self-paying patients usually account for a minority of your overall patient base, but taking certain measures when billing self-pay patients will ensure that you get appropriately reimbursed in a timely fashion without the stress and headaches.
Self-paying patients fall into one of two categories. That is, they don’t have any insurance coverage because:
- They suffer from a chronic or pre-existing condition and are therefore excluded from insurance.
- They consider themselves generally healthy and would rather pay on a medical case by case basis than regular monthly premiums.
- They can’t afford to pay insurance premiums with high deductibles because of tight budgets and other circumstances.
Or, self paying patients do have an insurance plan but also need to cover a deductible or a co-payment. Of course, some patients also neglect to get insurance coverage and employ schemes to get out of paying for medical treatment. These types of people are usually few and far between, and you can find legal ways to deal with them as well. With that in mind, let’s examine the top three medical billing issues along with suggestions on how to resolve them.
Medical Bills Confuse Self-Pay Patients
Medical practices often experience trouble with self pay patients because these patients don’t understand or are confused by the medical bills sent to them. Patients in some cases don’t know your expectations of them in matters medical billing, so make it plainly obvious for them. Start with an explicit payment policy for your office (if you don’t already have one). When your receptionist or other administrative coordinator schedules a patient for an appointment, the staff member should inform the patient of the payment policy and the fee for the first visit upfront.
Your payment policy may include some of the following essentials:
- Patients who are not covered by a health plan must pay for their medical care in full.
- Patients who are covered by a health plan are responsible for their deductibles and co-pays.
- Patients must pay for the medical treatment on the same day unless otherwise agreed upon in writing.
- A list of acceptable forms of payment should also be mentioned, such as what credit cards, debit cards, checks, etc. you accept and other financial details.
Make your patients aware of your payment policy by putting copies of it at the front desk or on a clipboard along with the rest of the paperwork they might need to fill out prior to treatment. Have your administrative staff explain and answer any questions about the payment policy before your patients sign that they understand and will abide by it.
According to a 2011 Intuit Health Study, 41% of all patients were uncertain about the accuracy of their medical bills and 57% of all patients didn’t pay their healthcare professionals, so their bills were sent to collection agencies. In most cases, patients didn’t know if they had to pay their healthcare providers or insurance company.
In order to leave zero possibility of any doubt, a medical bill statement to a self paying patient should contain four distinct components: clarity, accuracy, simplicity, and timeliness. Include the location and date of medical treatment delivered, health care provider(s) and patient names, specifics of the medical treatment, and the financial details (i.e. amount due, due date, and addresses for remittance to be sent to).
Self-Pay Patients Cannot Fully Pay for Their Medical Care
It’s not uncommon for patients to have difficulty paying their medical expenses, especially when they are uninsured or have high deductibles under certain health plans. If you find out that a self pay patient can’t pay the full amount for treatment right off the bat, you can approach this in a few different ways.
You can reschedule the patient for an appointment at a later date when full payment can be made upfront. You can also take a down payment on the medical treatment and work out the rest of the payment in installments. There is always the option of having the patient sign a promissory document, advising them of payment options, and then working out a payment plan with a set payment schedule. Get the patient’s agreement in writing about the payment plan and the expectation that it will be made good.
Your front office staff should follow up with patients on payment plans to ensure that payments are made according to schedule. If the patient gets behind on payments, keep in touch via telephone, text, email, or even letters to get status updates. Keep your tone firm but friendly when handling patients on this subject, and remember, strive to get your payments in as quickly as you can because the likelihood of a paid debt goes down with more time.
Some Patients Cause Trouble by Avoiding Payment All Together
You sometimes get patients who simply neglect to pay their full medical expenses or insurance co-pays despite the best collection efforts of your staff. You are within your legal rights to end a doctor-patient relationship, except in a medical emergency or in certain cases where medical care must be continued. The best way to terminate this doctor-patient relationship is to send an official letter by mail (keeping a copy for your records) with a message that you won’t render services to that patient as of a specific date. Give them at least a month’s notice before the termination takes place, so they have adequate time to find another physician.
Before you dismiss an insured patient, check their health plan contract to ascertain that you don’t have any obligations to that patient in it. A particular health plan usually contains a dismissal protocol for covered patients that you would also need to follow. For total legal protection, contact an attorney for state regulations concerning this type of issue.
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