Exploring Upfront Deductible Collection: Legal Insights

The healthcare industry has witnessed skyrocketing average deductible and copay rates in recent years. Furthermore, the upfront deductible collection is necessary, which is made difficult by the inflated costs of operating a medical facility. Additionally, outsourcing medical billing services to a professional provider can help streamline the entire process.

Methods for Upfront Deductible Collection

Below are winning methods for upfront deductible collection from the patients without sacrificing the patient-physician relationship.

1. Start of the year Patient Deductibles

Most patients haven’t yet met their deductible limit at the start of the year. Furthermore, it is important to remember that most insurance plans are renewed at the start of each year. As a healthcare provider, it is time to be extra careful with the beginning of the new year and encourage your patients to check their insurance company’s verifications. Either this, or ask them if they would rather pay themselves.
It is your patients’ choice to decide how to pay for medical services if their insurance company does not cover their bills. The entire scenario becomes a lot easier if you have an experienced team offering front-desk management and medical billing services.

2. Checking-In with Patients’ Insurance Companies

As some insurance policies offer preventive treatment, it gets challenging to sort patients who may or may not have copays or deductibles covered by their insurance. It means that your front desk needs to go above and beyond to check with insurance providers to ensure that authorized services are available. Doing so might result in additional phone calls; however, it is a reliable approach for determining the actual status of patient deductibles.

3. Inform Patients about Upfront Deductible Collection

It goes without saying that you need to remind your staff regarding the upfront deductible collection – your front desk staff must inform patients before they leave. Furthermore, healthcare practices should disclose this while confirming the appointment to avoid any awkward situations later on. When patients arrive, check their eligibility to see if there are any deductibles; if that is the case, inform them about the upfront deductible collection.

4. Upfront Deductible Collection at the Time of Service

Many providers contemplate whether is it legal to collect deductibles upfront – make it a rule for ensuring your financial stability. Upfront deductible collection during the services saves your practice from all troubles later on. It is not impertinent to request for payment beforehand. Almost all patients walking through your door will have prominent insurance coverage and may prefer to keep it silent until you say their status. It is not unnatural to inform your patients regarding their financial responsibility for the services they are requesting; instead, it is one of the best practices to maximize your collections.

5. Make Upfront Deductible Collection a Practice-Wide Policy

Give constant training and reminders to your staff to clearly express the copay and upfront deductible collection policy. Patients might come with many excuses to delay paying for services. It is advisable to instate automated systems for running patient verification protocols. What this does is assist in the verification of patient information in real time.

Patient information is easily accessible, and that too in mere seconds through EHR systems. With EHRs, you can stay updated and indicate a patient’s state-wise eligibility.

6. Offer Multiple Payment Options

Facilitate your patients with multiple payment options. If and when your patients have deductibles and don’t have cash on them, offer them solutions like:

Payment through credit cards
Any other digital payment method

7. Following-Up on Deductibles

If your patients quit your office without paying their deductibles, follow up with them. Payment follow-ups can be made by directly contacting them or sending them a reminder via phone calls or patient reports. Remember, unpaid patient deductibles can have a massive effect on the financial health of your practice.
To ensure that you are not losing money, keep your staff well-trained and aware of your practices’ collection policies. Doing so is only possible when your healthcare practice has an efficient billing procedure for upfront deductible collection.

8. Payment Plans and Discounts

Self-paying or patients with higher deductibles may request a discounted service price. You can entertain such requests for patients who are paying in cash. In contrast, insurance contracts mandate healthcare providers to charge a negotiated fee.
Talk to your patients, establish the insurance rate, and then give them a suitable discount if they pay in full-service time.
It is pertinent to note that you must train employees to arrange and manage payments—work by entering the minimum amount payable at the time of service, along with the maximum payment time. Facilitate your staff to create and then implement special payment arrangements.

Final Word

All of the tips mentioned above facilitate the upfront deductible collection process, that too on time. However, Physicians Revenue Group, Inc., is the right provider if you want a streamlined billing service. PRG offers a complete suite of billing, audit, RCM services, and many other healthcare practice management tools.

Frequently Asked Questions

What is the best way to define a deductible?

A deductible is the amount you pay for the covered medical services before your insurance starts to pay.

What is the key difference between a deductible and an OOP?

While deductible is the amount that patients pay before their insurance starts to pay based on the defined insurance policy, on the other hand, out-of-pocket (OOP) is the cap or limit over the amount of money a patient has to pay per year for covered service before their insurance plan starts to cover 100% of the cost of services.

What is the key difference between deductible and copay?

Both copay and deductible are out-of-pocket expenses. A copay is a fixed amount paid by the patients at the time of receiving services. In comparison, the deductible is an amount a patient pays before their health insurance starts to cover the outlined benefits.