It is here again. The slowing of the number of patients who wish to receive treatment because of their new deductible. There are three different paths we see practices take in collecting patient deductibles and co-insurance. I’ll review the three paths and then offer our recommendation.


Dolittle Approach: The practice basically assumes that the patient is aware of their deductible and coinsurance amounts or they do not want to scare the patient away. Treatment is rendered and then a bill is sent to the patient.


Middleton Approach: The practice provides some financial review with the patient and attempts to collect a portion of the deductible up front. Payment plans may be established or the practice helps subsidize something like CareCredit.


Strongarm Approach: The practice essentially asks for payment of the deductible and all co-insurance monies up front or during the course of treatment.


Unsurprising, we recommend a middle ground approach. The Strongarm Approach helps ensure patient balances remain low, but it does come with a cost. We have heard of patients seeking care elsewhere because it ‘feels’ to the patient that the practice only cares about money. As it is impossible to ascertain what other claims may be paid before your claims are paid, it is very common to over collect patient monies and then have to refund these credit balances regularly.


Likewise, the Dolittle Approach can create a jarring bill after the insurance adjudicates the claim. We receive calls from the patient who is most unpleased that they never knew they would owe this amount of money. I will admit my own personal confusion on why the patient does not know what their deductible is on their policy but, it does happen all of the time.


By providing some basic financial counseling, by collecting part of the deductible up front, you help to ensure that the patient is neither surprised nor someone who will never pay their portion. Establishing realistic payment plans, that the patient signs, is extremely helpful when your accounts receivables person is attempting to gain further patient payment on the outstanding balance.

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