Don’t Let High Deductibles and Co-Pays Create Chaos in Your Practice

Member Providers

Dr. R. A. Foxworth, FICC, MCS-P

More and more providers are feeling the effects of high deductible health plans when it comes to reimbursement and patient collections. Although the Affordable Care Act has lowered uninsured rates in the U.S. from 15.7% in 2009 to 9.1% in 2015, the number of patients delaying needed health care continues to rise as more of the cost-sharing has shifted from government and third-party payers back to the patient.

As deductibles continue to creep upwards at a faster rate than workers’ wages, and as the number of patients enrolled in high-deductible plans increases, a greater number of insured patients have reported difficulty paying medical bills. With average fees totaling $300-$500 for an initial patient visit, it is no surprise that some practices are seeing fewer new patients and even fewer of those are making a commitment to care. Patients are looking for access to affordable care in your office, but before offering a “cash” discount, remember that offering deals to patients outside of a contractual discount (PPO, MCO, DMPO) can put your practice at substantial risk of fines and penalties.

The best way to keep patients happy, improve clinical outcomes, and enhance collections in your practice is to clearly and openly discuss your fees and payment policy upfront. By conducting a formal Financial Report of Findings in your office, you can clearly outline your treatment plan and the patient’s estimated out-of-pocket expense. Now, more than ever, we need to educate our patients on what their insurance will pay for and what is their own financial responsibility.

We also need to offer affordable payment options, while still maintaining a compliant practice. One of the simplest ways to do this is by offering automated payments. This is a great tool to ensure that your patients complete their recommended care, reduce missed visits, and eliminate the sting of out-of-pocket payments at the end of each visit. In fact, orthodontists have successfully used this technique for years.

As a ChiroHealthUSA provider, you are one step ahead when it comes to offering affordable care to your patients. Use this time at the end of the year to help your staff brush up on their conversation skills when it comes to discussing care with your patients who will have unmet high deductibles when you return in January 2018. Watch our conversation videos (#5 Initial Visit – Patients with High Deductibles and Co-Pays) and review our sample scripting on your provider resources page. Preparing your team today will help to launch your success in the new year.