Multiple factors, all of which are interconnected, will determine how fruitful your practice is. Important metrics include patient care and satisfaction, as well as revenue. Even though they each call for a unique strategy, they both depend on each other to be successful. If you don’t have enough money or revenue, you can’t give your patients the best care possible. Dealing with insurance payouts and patient payments like copays in the event of patients lacking insurance can make revenue management in medical practices a complex task.
Determine eligibility for insurance and benefits.
Provided that revenue determines the quality of patient care, you should ensure that your patient is covered by insurance. This expedites the claims process and expedites plan payments to your service. However, not every one of your patients will be covered by insurance. It is essential that you verify your patients’ insurance coverage prior to their appointment so that you can collect payment on the day of their appointment if they are not covered. In addition, it is possible that your patients have insurance coverage, but the benefits may be limited. This means that the plan may not cover your services, and the patient will be responsible for payment at the time of service. Practolytics assists its clients with benefits and eligibility verification well in advance of the patient’s appointment and provides you with crucial financial data before the patient is seen.
Collect Payments at the Time of Service
Non-insured patients are required to make payments at the time of their appointment. There are a number of different types of payments that the patient will be required to make, and it is essential for payment management that you and the patient are familiar with these terms. This knowledge, coupled with verification of benefits, enables your service to anticipate the patient’s potential financial responsibility. And this information can be communicated to the patient via appointment reminder calls or emails.
What are Deductibles?
Copays and coinsurance are the terms commonly used to refer to the payments that patients, including those with insurance, frequently make. Before you can understand what these two are and how they differ, you must first understand what a deductible is.
A deductible is a fixed amount that a patient must pay before their insurance coverage begins to take effect. For example, if the deductible on the patient’s plan is $1000, the patient is responsible for paying that amount before the insurance will cover any of the patient’s expenses.
What is Co-Pay?
Copayment is a fixed amount that your patient must pay at each visit. This amount is payable regardless of whether the patient’s deductible has been met. The copay can be as low as $10 and varies based on who was seen, such as a primary care physician or a specialist.
Copayments are applicable beginning with the first visit after insurance, but do not count toward deductibles. For example, if the patient’s deductible is $1000 and their copay is $50, even if they pay you $50 the first time, they must still pay $1000 before their insurance kicks in.
What is Co-Insurance?
Copayment is a fixed amount that your patient must pay at each visit. This amount is payable regardless of whether the patient’s deductible has been met. The copay can be as low as $10 and varies based on who was seen, such as a primary care physician or a specialist. Copayments are applicable beginning with the first visit after insurance, but do not count toward deductibles. For example, if the patient’s deductible is $1000 and their copay is $50, even if they pay you $50 the first time, they must still pay $1000 before their insurance kicks in.
What is an out-of-pocket expense?
The patient’s out-of-pocket expense is the amount that is not covered by insurance and must be paid. This amount is accompanied by an out-of-pocket maximum, which is the maximum amount a patient pays out of pocket. Once this maximum has been reached, your patient is no longer responsible for payment, and insurance will cover the remaining amount of their medical costs.
How to Increase Payment Collection at the Point of Care
It is vital for your practice’s payment management that you understand how to increase payment collections at the appointment. Although you and your patient may have mutual understanding and trust, it is not recommended that payment collections be delayed, especially if the payment is from the patient. To avoid delays, payment should be collected at the point of care, which you can do by following the tips listed below.
1. Make payments process transparent
When informing patients of their upcoming appointments, it is also important to notify them of the copayment or coinsurance required for the appointment. This assists the patient in coming prepared to make payment. Moreover, they are less surprised than if they had to find out at the point of service. If a patient chooses not to pay, they can cancel the appointment beforehand, giving your practice an opportunity to fill the space. But patients cannot do so if they are unaware that payment is required.
2. Have user-friendly online payment options
The majority of people around the world prefer contactless payment methods like contactless cards and online payments. Ensuring that your service is prepared to accept these types of payments ensures patient convenience, which boosts payment collection at the point-of-care. Practolytics provides you with all of the tools you need to process online payments quickly and easily, resulting in less paperwork and administrative burden.
3. Make sure your office staff is prepared to have challenging conversations about finances.
Your staff should be able to decipher insurance terminology and what it means for the patient. As finances are a sensitive topic in healthcare, they should be able to relay this information to patients before the appointment in a friendly and calm tone. They should not come across as greedy or unconcerned about the patient’s health, but they should also be firm and clear enough that the patient understands. This improves patient comprehension and rapport with the practice, as well as increases patient payments during appointments.