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Deductibles and Copays – The Lifeblood of Your Business

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There was a time when a medical practice could stay afloat on just the payments it received from insurance companies. Those days are gone.

Today’s reality is that now over 30 percent of revenue stream comes from deductibles, copays and coinsurance. In order to stay on top of your revenue, it is important to collect everything you can from these revenue streams and these collections should be an area of continuous improvement.
In order to do this, it is extremely important that your patients understand your policies from day one. There are several strategies that will enable you to collect more from your patients, both pre- and post- service.

By letting your patients know their copay and that it is due at the time of the service, the expectation is that patients will need to bring a form of payment to their visit—if they haven’t already made a deposit and/or commitment to payment plan pre-service. This action gets the conversation about payment started right away; a conversation that is not as difficult as you may think.

It is also a good idea to put your billing practices in writing, available to them pre-service via website or automated email. When patients arrive for their first visit and if they haven’t accessed the policy pre-service, handouts explaining your policies can be offered. Not only is a having a written policy a great way to get patients involved with their health and help them understand that they are accountable for anything their insurance doesn’t cover, this is a great opportunity to provide some free education.

You must also have a billing and collections policy in place and stick to it. Setting expectations requires more than just posting a set of billing policies. If you expect patients to comply with your policies, you must stick to those policies, too. Of course, you can (and should) make arrangements with people who can’t afford to pay, including providing a financial assistance application. But you must also have a detailed policy for financial hardship, and everyone needs to understand and follow that policy.

The ultimate foundation to making all financial policies and procedures effective is clear, up-front communication with patients. If you want fewer collection problems down the road, clearly communicate your policies from the beginning… before they arrive at your facility whenever possible. In today’s billing environment, it can make the difference between running a profitable practice and going under.

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