Recently I have been seeing numerous online article titles discussing the stress caused to patients over the cost of their cancer treatment.  Some titles are:

New Adverse Event in Cancer Treatment: 'Financial Toxicity'

Proposed: A Scale for Financial AEs and Cancer Treatment

Out-of-Pocket Costs More Stressful Than Cancer in Texas

In reading through these articles, the main theme is of course about the stress caused by high medical bills and the effect of that stress on the patient’s health and impacts on treatment decisions.
 

I don’t think that theme is unique to cancer treatment.  It is probably very common for patients to consider the out of pocket expense of a procedure/office visit before choosing to follow through with the medical service. I know for myself, I have been hesitant to go for pulled muscles and such, instead just waiting them out.
 

Medical billers are well aware of the growing trend in insurance policies that have increased the patient’s financial responsibilities significantly.  There are high deductible plans, like $5000, which doesn’t pay for non-preventive services until the patient reaches that plateau.  Even if met, the patient is likely to be responsible for the remaining 10%, 20% or 30% of a bill up to another large “out of pocket” maximum amount that can be thousands of dollars also.
 

Even prescription and office co-payment amounts have seen large increases.  The days of a $10 office visit with the PCP are few and far between.  
 

In the medical office, there are a few workflow suggestions that can help alleviate the stress for patients and staff when collecting the out of pocket expenses.

Knowledge is power.

Front office staff should take complete insurance information when scheduling a new patient.  As soon as possible before the assigned appointment, the eligibility and benefits should be checked.
 

In Iridium Suite medical billing software, you can perform a real time eligibility request in under a minute for Medicare, Medicaid and large commercial payers.  Benefit details can show co-payment amounts, deductible amounts with amount met, co-insurance rates, and total out of pocket.  Some will also indicate authorization requirements.  With this information readily available on check-in, any co-payment can be easily collected at time of service. Get a free demo today!

Not everyone likes a surprise.

Once a patient is seen and further services are ordered, the detailed benefit information can be used to estimate the patient’s financial responsibility.  Staff will be able to advise a patient of a potential large out of pocket cost before a service is rendered.  It may even help the patient decide between two different recommended services based on the cost.

Flexibility is good.

When faced with a large out of pocket balance, staff can discuss payment options with the patient and decide on an amount that is comfortable for both.
 

If a payment plan is required, Iridium Suite allows the user to set up the amount on the patient amount and the due date of the first payment.  When statements are generated, the current account balance will be shown with the payment due amount equal to what was agreed upon.

Our medical coding software has many features to optimize your revenue cycle management.  Contact us today sales@iridiumsuite.com