The Affordable Care Act is now entering its second year. With continued implementation of its many provisions, both patients and providers are still getting use to the new law. 2015 will see a steady increase in the number of patients becoming insured-many for the first time. With higher out-of-pocket costs, more and more patients will become financially responsible for larger portions of their claims. Therefore, as a provider, it is integral to set financial policies in place, so that you are able to collect all monies for your services.
In an effort to assist providers with collections, we have put together a few strategies any organization can implement:
- Establish a financial policy. Practices should establish a financial policy that is reviewed and distributed every year. This comprehensive policy should provide patients with a clear understanding of the practice’s expectations with regards to patient balances. Make sure each patient signs a copy which you should keep in his or her file. Please note, it is important to update your financial and insurance verification policies annually to reflect requirements of your individual practice.
- Collection of patient demographic and insurance information should be obtained when the patient makes the appointment. Make sure to enter insurance information into the system prior to the visit for eligibility verification. Advise each patient in advance to bring a copy of current insurance cards, applicable co-pays, and any deductibles owed. We also suggest that you advise your patients to verify benefits with their particular insurance company prior to the appointment. This way, the patient thoroughly understands his or her contractual obligations.
- Eligibility verification process. For providers that use our software, Caretracker/Optum PM and Physician EMR, it performs an automatic eligibility check for the next five dates of service. Each patient’s eligibility history is automatically updated when their check is complete. Other systems may work differently and it is important to utilize this functionality to capture your patients’ current insurance information. If you do not have software that checks eligibility, we suggest that you designate a staff member to verify your patients’ insurance prior to visits.
- Co-pay collection. Practices should collect applicable co-pays prior to visits.
- Payment plan. With higher out-of-pocket costs and increasing premiums, there’s a good chance there will be a patient who is unable to pay for a service at the time of visit. For situations like these, it may be helpful to set up a payment plan with a promise to pay. Draft a form and make sure the patient signs it. Give the patient a copy and keep one in your accounts receivable section. This way, you will be alerted with a reminder to process a credit card, or collect cash or a check. Be sure to always follow up with a patient who has not paid on time.
- Credit cards. Another great option for your organization is to have a credit card machine. Credit cards are a safe option to ensure payments are made on time.