Problem: Many practices don't research a patient's coverage and responsibilities prior to the patient's appointment.
Solution: Always collect full insurance information when the appointment is made and verify the patient's coverage beforehand.
Predicting what a patient will owe for a visit or procedure is an inexact science, but most information systems today allow you to come fairly close, says Mike Fleischman, an Atlanta-based consultant. In the case of an overpayment, practices must simply be prepared to refund the money promptly, such as within 30 days, he says.
Making a daily effort to manage all types of over-the-counter balances (high deductibles, copays, coinsurance and outstanding balances) will pay dividends in avoiding the often-futile and expensive (at a cost of up to $4 per statement) work of sending bills later, our expert sources agree.
For example, some high-deductible plans allow practices to collect fees only after the patient's claim has been processed. Such a restriction could have a major impact on your accounts receivable, but it's possible to negotiate with the payer to relax this requirement, says John W. McDaniel, a New Orleans-based consultant who also has served as president and CEO of several healthcare systems.
And keep in mind: Typically, about half of your patients will have met their high deductibles by the end of July.