Medical Debt Collection and Health Insurance: A Brave New World

Posted by Marilyn Miller on February 12, 2020  /   Posted in Uncategorized

Medical debt collection is different today as larger insurance deductibles and higher out-of-pocket costs are passed on to consumers.  

Now more than ever, communication with patients is important. 

Health insurance policies are confusing. Many medical debt collection problems can be avoided if you clearly communicate your payment expectations and policies. Also, while it is true that patients should know what their policy covers and how much they can expect to pay out of pocket, in reality, you really need to help them understand. 

Whenever possible, verify insurance  before each visit. Review benefit terms and limitations in writing with the patient. Ask them to sign the review and keep it in their chart.

The number one question I hear from patients placed in collections is, “Why didn’t my insurance pay?”

When we take the time to walk someone through the insurance billing – sometimes explaining what terms like deductible, co-insurance, etc mean – most of the time they pay the bill or enter into a payment plan.

If a patient has a large deductible, ask them to sign an acknowledgment of that fact, as a separate document and keep in their chart. This one step will save problems down the road.

Make it easy for patients to pay you.

Clearly indicate your hours of operation if you allow patients to make payments in person. Consider an online payment portal. 

If patients enter into a payment plan with you, make certain the plan is in writing and that the patients signs the form. Remember that a signed payment plan is a sort of contract, and a contract must be bilateral, meaning both parties must agree. Oral contracts are not enough – they subject you to the memory of someone else. Get it in writing!

Explain to patients that patient responsibility is based on their insurance policy, and that you are simply following the terms and conditions of their policy. I am not sure why, but some patients want to blame their physician, (and by extension, the collection agency) for any out of pocket costs. Patients should be informed (and agree, in writing) that their insurance contract is between insurer and patient, and that they are responsible for the cost of treatment. 

I know, I know…you do not need more paperwork. However, if you set your systems up right at the beginning, the process should flow smoothly, and the documentation will benefit you in the long run. 

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