Surviving in a world of high deductibles: Collecting payment at time of service

January 18, 2016

With the growth of high deductible health plans, patients are now financially responsible for a larger piece of their health care costs. As a result, collecting copays, deductibles and coinsurance directly from patients is fast becoming a major focus for allergy and immunology practices. What are some of the best practices to help capture this patient revenue at the time of service?

  1. Many practices now expect patients to pay deductibles and coinsurance, in addition to copays, at the time of service. Make sure your financial policy clearly states expectations, and require every patient to sign it. See a sample financial policy.
  2. Preregister all patients when scheduling appointments. Collect or confirm both demographic and insurance information up front, and explain the payment policy. Patients who know what to expect will not be surprised when asked for a copay or deductible at the time of visit.
  3. Verify insurance benefits prior to the patient’s visit. Where possible, confirm eligibility, benefits (for skin testing, allergy shots and other specific services), copay, coinsurance, deductibles, effective date and referral requirements. Most practice management systems have this capability, but there are also stand-alone systems that can confirm benefits. Alternatively, this information is also available through individual payer websites. Once this information has been obtained, your practice will be able to determine the patient’s financial responsibility for the visit.
  4. Prior to the appointment, provide the patient with an estimate of their costs for items such as skin testing or allergy shots. Many insurance plans only partially pay for these services, so patients can be left with a big balance. Communicating this to the patient up front will eliminate surprises. Collect all patient balances prior to providing the service.
  5. Consider collecting credit card information from patients to keep on file. (Be sure to use a merchant service vendor to store credit card information securely! No one in your practice should be able to access credit card data once it is collected.) Having credit cards on file allows for automated payment processing once the Explanation of Benefits is received. It also eliminates the need to send costly paper statements to patients; instead, it sends patients a receipt once the charge is complete. See a sample credit card on file policy.
  6. Develop scripts for front desk staff and coach them on how to initiate the payment conversation. This does not come naturally to many, so roleplaying and practicing are essential. For example, rather than ask “Mr. Smith, would you like to pay your copay today?” say “Mr. Smith, I see that you have a $20 copay today. How would you like to pay? We accept cash, credit, debit or check.” Don’t give the patient an option NOT to pay. See sample communication tips.
  7. Shadow each front desk employee to observe both phone conversations and the patient registration process firsthand. Coach associates to ensure adherence to practice policies. This part is essential – viewing the process firsthand will show you what is and is not working. You may be surprised at the results!
  8. Set practice goals for copay and patient balance collections and engage staff in the process. Track these metrics and be transparent with reporting. Celebrate success and reward employees with a team lunch or party.

For more information, watch the College’s “Perfecting Practice” webinar by Jason Biddy, MBA, Administrator, Alabama Allergy and Asthma Center, LLC, titled best practices in office collections. You can also find samples of a Patient Financial Agreement, patient payment estimate worksheets and insurance verification forms.