Adjusting Your Collection Strategies to HDHPs

Categories:   Collections   Insurance  

High Deductible Health Plans (HDHPs) are recent and growing trend in healthcare that is probably here to stay, regardless of the future changes to the national healthcare system or federal regulations. Even if they are phased out for one reason or another, your practice’s collections department will benefit greatly from having a firm handle on its methods for high patient bills, which can occur with or without HDHPs in play.

Some sources suggest the high deductible trend in healthcare may actually be helping the economy by keep[ing] overall costs down—a major priority for healthcare reform. According to Medical Economics, HDHPs discourage patients from seeking medical care when it’s not absolutely necessary. Because patients are aware that they will face relatively high out-of-pocket costs for emergency care visits or other non-preventative services, they will avoid visits where possible.

This reluctance to visit a provider takes some of the stress off the system and can help prevent high practice collections numbers, since patients will be unlikely to seek medical care unless they truly need it. The flip-side, however, is that patients may distance themselves from healthcare professionals and avoid important healthcare needs. Unfortunately, the latter concern has turned out to be an unavoidable side effect of HDHPs, one that is being mitigated by two other trends in the industry: health savings accounts (HSAs) and telemedicine.

HSAs are tax-free accounts for healthcare spending, while telemedicine is a less expensive appointment method conducted via internet or phone. Both are making the healthcare costs more affordable for the average consumer, but not every practice or consumer has these options to fall back on. For that reason, effective practice collections methods are vital.

Below are some strategies your practice can adopt to make high patient bills and HDHPs more manageable.

Educate Your Patients
Your patients need to be informed up front about their obligations and—most importantly—their options. Many patients may not even be aware that many preventative services and some types of screenings are not subjected to deductibles and may even be covered at 100 percent. By attending proactive screenings, many patients could avoid certain costs and maintain a better overall level of health.

Be Transparent
Patients who are more aware of the costs they could owe as a result of care can make better decisions. They can also plan accordingly before they seek care that they may or may not be able to cover outright. With full disclosure from your practice about costs and payment plan options, you can keep practice collections numbers within acceptable ranges and prevent HDHPs from causing problems.

Research and Be Proactive 
As soon as a patient starts with your practice, it’s important to do the research immediately to understand expectations. Verify with insurance and set clear expectations with your patient. Also, for each appointment, or whenever you speak with the patient, remind him or her of the expectations, copays, potential costs, and the options for covering those costs.

Give Them Options
In the era of HDHPs, it’s important to develop alternative payment options for your patients. Once they are informed of the costs, patients who are aware of payment arrangement options will be more likely to make informed decisions with the intent to fully pay any healthcare bills they accrue. Making payment options available to your patients is beneficial for both your practice and patients facing high out-of-pocket costs.

Ultimately, practice collections can be managed more efficiently when you maintain effective policies for keeping patients informed and up-to-date on their healthcare bills. With a few small policy changes, HDHPs don’t have to cause problems for your practice. Protect your bottom line with transparent, proactive, and creative payment policies.
   

---

About the Author - Ashley Choate is a native of Jacksonville, FL where she lives with her son, dog, and three cats. She graduated Magna Cum Laude from Jacksonville University with a BA in English and holds an MAED in Adult Education and Training. She lives for reading and writing, learning and teaching, and figuring out the day-to-day traumas and joys of mommyhood.

We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 

Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.

Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.

According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.

With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.

COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.

2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....