The proliferation of high-deductible health plans has not only caused hardship for patients, but has added a difficult layer of administrative and financial burden for physician practices and ambulatory surgery centers.
The challenges of collecting balances from patients are multi-fold, with practice managers and consultants citing the following issues:
1. Despite the movement toward consumer-directed care, patients still rarely understand insurance terminology such as deductible, copay and coinsurance, and how they translate to out-of-pocket expense. Often patients don’t even realize they have a deductible until they need expensive care.
2. Collecting reimbursement from patients is far slower than collecting from insurers, and is slowing practice revenue streams as a result.
3. Practices can experience a “Catch-22” in discussing patients’ bills before providing service. We don’t want to make it about money nor do providers want patients to forego care. Bad debt is a major risk. One billing company said one of its client practices has seen its outstanding accounts receivable double in the last four years, as a direct result of patients who can’t pay their deductible at the time they receive care.
4. Patient collections require a special skill set. Under federal law, for example, there are only certain times of the day a creditor is allowed to call about an outstanding bill. Collecting from the patients requires knowledge and an attention to detail.
As a result, practices need to update their collections strategies to rise to these new challenges.