Medical Debt: Patient Payment Issues and How to Avoid Them

Posted by Marilyn Miller on February 08, 2019  /   Posted in Uncategorized

Medical debt in the United States is growing. Although the Affordable Care Act has made insurance coverage available to many, out of pocket costs are rising, which means more patients are struggling to pay medical bills.

Now more than ever, communication with patients is key. Good communication can help avoid patient payment issues down the road.

Here are some common comments we hear from patients that are referred to us for collection, and things you can do to help avoid issues.

“Why didn’t my insurance pay?”

Often it is not that insurance did not pay, but that they did not pay 100%. However, health insurance is confusing. A good part of medical debt collection involves explaining how an insurance processed their claim. As much as possible, verify coverage before you see a patient and review expected insurance payment and out of pocket costs with them. Be mindful to explain any limitations or waiting periods. Clearly list any out of pocket costs. Ask client to sign the form, and keep in their chart.

If you are out of network with a provider, make sure the patient signs in advance that they understand this fact, and sign in advance that they are responsible for payment if insurance does not pay. The same holds true for self pay patients.

“I did not realize I had a deductible”

I list deductibles in a separate category because they have really changed medical debt collection since more and more people have larger deductibles.  As part of your new patient packet, include a form for patients with large deductibles, and ask them to acknowledge, in writing that they understand. 

“My ex is responsible for our payment of our kids bill”

Institute a policy immediately that states that the person bringing child to your office will be responsible for payment, no matter who has the insurance. Have parent sign before you see the child. DO NOT get involved in their squabbles. You are not a party to the divorce, so do not let parents drag you into their drama. 

“I had a payment plan with the doctor”

People often remember the part of the deal that works for them. Some remember that they have a payment plan, or that you offered a discount, but forget that they actually have to pay, or that the discount was based on prompt payment. 

Document all payment plans. If you make an offer to provide a discount, do it in writing and also advise that the discount is a limited time offer, and will be pulled if payment not made by the due date.

It may seem like this advice will lead to more paperwork, and it might, but if you have the forms ready for new patients and make your standard operating procedure, it should not put a burden on your staff, and will benefit you in the long run. 

We also recommend having patients re-sign new financial agreements every year. My lawyer once lost a case in court because the patient financial agreement was five years old, even though the patient had been receiving services all along.





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