Are appropriate Patient Collections being affected by High Deductibles?

1
(No Transcript)
2
Are appropriate Patient Collections being
affected by High Deductibles?
It has been observed, that since 2008 and after
the Affordable Care Act (ACA) has come into
being, there has been a major doubling of
patients with high deductibles plans. People
often have picked a high deductible plan because
it has a lower premium and out-of-pocket expenses
are lower and can fit into their budget.
Unknowingly, patients, thus end up paying more
out-of-pocket expenses on their
healthcare. Moreover, employers too prefer high
deductible plans for their employees as this
saves money on healthcare coverage. Further, the
ACA has been one of the major factors that has
pushed up the number of people taking on
healthcare high deductibles plans. The impact of
this is not really favorable to either parties
the patients or the hospitals/physicians
attending to them. For the patient, once they
realize that the healthcare insurance plan is not
giving them total coverage, they are reluctant to
seek further preventive care. And the negative
impact on the medical practice, high deductible
takes its the toll on the medical Revenue Cycle
Management (RCM). Patients with High deductibles
affect patient collections in various ways High
Administrative Costs
3
Are appropriate Patient Collections being
affected by High Deductibles?
High deductibles and/copays are stated to be one
of the major challenges that medical billing
services face. Since patients think that having a
high deductible insurance scheme gives them total
coverage, often they end up not being able to
make the payment, and hence it is left to the
billing services to chase the patients and leads
to more paperwork than necessary. A recent
research study found that uncollected deductibles
ruin practices and that nearly 81 percent of
self-pay net revenues go unrecovered, leading to
twice the expense of administrative costs for
collecting from a patient when compared to that
from a payer.   Physicians dilemma Physicians
often find themselves in a dilemma, especially
with people with high deductibles, in cases where
medical treatment is critical. If the healthcare
plan does not cover the appropriate treatment
required, the appropriate patient collection
upfront could be a tricky job for the physician
as the inability of the patient to pay for
treatment could lead to bad debt on the patients
side. Moreover, physicians have to maintain that
fine balance between maintaining that personal
relationship with their patients and collecting
their dues seamlessly without effort.
4
Are appropriate Patient Collections being
affected by High Deductibles?
Increase in Out-of-pocket-Payments The
healthcare providers are all too aware of the
unique complications inherent in the medical
billing service with respect to high deductible
plans lack of knowledge about what to bill at
various points in the revenue cycle management
process is the core dilemma. It has been noted
that, based on the study of Americas Health
Insurance Plans (AHIP), the growth in High
Deductible Health Plans is a major contributor to
current expectations and it has been observed
that the out-of-pocket payments for insured
patients is expected to grow to 420 billion by
2015 from the 250 billion that it used to be in
2009. This could lead to bad debt on either side,
patients as well as the medical
practice. Increase in Accounts Receivable In
the recent past, nearly 50 percent of patient
revenue would be uncollected and may not have
been so detrimental to the practice. But today,
failing to collect an upfront fee from patients
can lead to a loss of 15 percent or more of
revenue, weighing down A/R and increasing costs
to collect thus affecting the Revenue Cycle
Management (RCM).
5
Are appropriate Patient Collections being
affected by High Deductibles?

• If healthcare practitioners enable certain
  payment schemes among the high deductible
  patients, then the process of patient collection
  services becomes manageable and thereby
  streamlines the RCM process without any loss to
  either party.
• Some of the options like
• Communicate payment policies upfront- During
  scheduling appointments, communication material
  for walk-ins, better front desk interactions that
  help explain it all.
• Providing different schemes for payment- This
  could involve interacting with the types of
  insurance schemes your patients have and help
  them understand what is covered and what type of
  insurance could benefit them having credit card
  payments accepted at the front desk, and even
  providing them a low credit risk installment
  payment option.
•