Collecting Deductibles, Co-Pays and Co-Insurance in Your practice

###Collecting Deductibles, Co-Pays and Co-Insurance in Your practice###

It's a fact that many of our patient's have unmet deductibles. Deductibles are the number of money that your sick person has to pay out of pocket before their insurance firm will begin to pay their claims.

Medicare Part

To clarify, it's also foremost to understand how this is distinct from co-pays and co-insurance. Co-pays are the number of money that an individual's insurance states they must pay upfront for each and every visit. Co-insurance is commonly the 20% that an private (or secondary plan) must pay after figuring in the allowed amount, minus the co-pay. And of course, the deductible is the number of money your patients must pay out of pocket, prior to the insurance firm paying any of their claims.

Deductible amounts will vary from policy to policy. The Medicare 2011 deductible rate is 2.00. Various market policies will have deductibles ranging from a few hundred dollars to more likely ,000 or ,000 or even ,000. Knowing the number of deductible and collecting it is imperative for the financial condition of your practice.

Another point...it's likely written into your insurance contracts and failure for you to accumulate co-pays, co-insurance or deductibles leaves you potentially open to accusations of fraud. There is something called the "False Claim Act", which would leave you subject to prosecution for fraudulent billing under federal law. Know your contracts and thus your requirements. Adequate said.

So what can you do to maximize your collections?

First and foremost, understand your private contracts with third party payers. You'll need to be aware of when you can accumulate deductibles (some prohibit you from collecting prior to providing services). Additionally, some services, commonly preventative services may not be subject to co-pays, co-insurance or deductibles.
Review your financial policies on a quarterly basis. Make sure patients understand their promulgation upfront. Remind them every year about deductibles, and beyond doubt every visit if necessary. I still have population who tell me they were unaware of this being an yearly promulgation on their part, and some Medicare patients who tell me I'm the only one who has ever collected a deductible.
When verifying insurance, do what you can to confirm if the deductible is met or not. This is not all the time easy, especially if patients are finding multiple providers the first few months of the year.
Work with your staff to teach them how to accumulate money, what should be said and not be said to patients and how to rejoinder to objection beyond doubt and respectfully.
Most patients will want to pay their bills, make it easy for them by providing multiple ways to pay such as cash, check, credit or debit card.

Good financial policies, fair variety practices and excellent study of your staff and patients will go a long way in avoiding any problems when it comes to permissible variety of co-pays, co-insurance and deductibles.

Steps You Must Take

Review your insurance contracts Review your financial policies. Tweak them if necessary Spend some time with your staff to present their practices and make sure it's consistent with your policies and that of your contracts. If you need a merchant account, check out Carolyn Zaumeyer's service for clinicians, fdispink. You can find her site on the web.

Collecting Deductibles, Co-Pays and Co-Insurance in Your practice