In the past, most medical practices were content to collect co-pays from patients and go after health plans for the rest of what they were owed. They did this, in part, because they just weren't sure what the final bill would be, given the complexity of health plan payment policies.
Today, however, it's getting far more common for practices to collect the entire balance owed by a patient up front before they'll initiate treatment. Practices are able to collect more aggressively of late because software that can estimate final patient charges is becoming more widely available, taking the mystery out of what a patient truly owes.
A growing number of health plans have already begun offering such software, including some Blue plans, UnitedHealthcare and Humana. Cigna, for its part, plans to get on board in April with "The Estimator," a software tool that estimates patient financial responsibility on the spot. (It appears this software is focused on medical practices, but hospitals will probably want to get into the act too.)
Cigna is recommending that doctors ask for no more than half of a patient's estimated bill at the time of care, but doctors can still do whatever they think best.
To learn more about this trend:
- read this story from The Washington Post
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