Prioritize Your Patient's Financial Experience

May 13th, 2019 - Wyn Staheli, Director of Research
Categories:   Billing   Collections   Practice Management  
0 Votes - Sign in to vote or comment.

For many years, the ChiroCode DeskBook has emphasized the need for providers to firmly establish the patient’s financial responsibility through clear communication. We even created a “Patient Financial Responsibility Acknowledgment Form” to help providers with this process. Lately, the lack of pricing transparency has been in the news and even the Affordable Care Act (ACA) attempted to make things better by requiring hospitals to make their prices transparent by publishing their “chargemasters.” However, there are still problems.

Although “surprise” bills are particularly problematic when it comes to hospital bills and imaging services, they can also happen in a smaller organization. When a patient finds out that the procedure or service is not covered by their insurance, as you can imagine, they are not happy about it. Even as a practice, it is often difficult to find out what is covered by a third-party payer.

The best place to begin is to make sure you have an “Informed Financial Consent Policy” which is an official written policy. As part of your policy, you need to make sure that your office has a process which outlines anticipated procedure/item costs and helps the patient understand the role of their insurance. Medicare requires the use of an ABN for noncovered services, but you also need to have a separate form for non-Medicare patients.

A recent article in Medical Economics (see References below) emphasized the patient’s focus when it comes to healthcare services. According to the article, their top priority is affordability. You need to be able to show how your services are affordable compared to other physicians or services. As you’d expect, they also stated that convenience is also essential. Seventy percent of the patients surveyed wanted to be able to sign up for a payment plan online. If your organization is prepared to be able to offer online payments and/or payment plans, just make sure that you meet all security requirements.

Patients also look for a ‘deal’. Just keep in mind that you have to be careful with marketing to ensure that you do not violate any laws. For example, you can’t offer to waive co-insurance or deductibles for either new or established patients. Medicine isn’t like other businesses in that you have to be careful about offering any ‘inducements’.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

CMS and HHS Tighten Enrollment Rules and Increase Penalties
October 1st, 2019 - Wyn Staheli, Director of Research
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019. There have been known problems ...
Federal Workers Compensation Information
October 1st, 2019 - Wyn Staheli, Director of Research
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...
E-Health is a Big Deal in 2020
September 16th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
The new 2020 CPT codes are on the way! We are going to see 248 new codes, 71 deletions, and 75 revisions. Health monitoring and e-visits are getting attention; 6 new codes play a vital part in patients taking a part in their care from their own home. New patient-initiated ...
Chiropractic 2020 Codes Changes Are Here
September 9th, 2019 - Wyn Staheli, Director of Research
There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing?
Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?
September 9th, 2019 - Wyn Staheli, Director of Research
Question Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI? Answer You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...
List of Cranial Nerves
September 3rd, 2019 - Find-A-Code
Cranial nerves are involved with some of our senses such as vision, hearing and taste, others control certain muscles in the head and neck. There are twelve pairs of cranial nerves that lead from the brain to the head, neck and trunk. Below is a list of Cranial Nerves and ...
So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?
August 21st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from?  It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems.  One of the ...



About Codapedia by InnoviHealth Systems Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™ by InnoviHealth Systems™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2019 Find A Code, LLC - CPT® copyright American Medical Association