Your medical practice cannot afford to allow patients to be billed for their copayments and deductibles.
Did you know it is illegal to routinely waive deductibles and copayment amounts? Most insurance carriers do not tolerate this practice because it is a breach of contract. They may view it as giving a patient a discount and making the insurance company pay 100% of the fee. If audited, the federal government can assess penalties for not colelcting deductible payments for patients see with Medicare benefits.
However, if deductible or copayments are waived for legitimate reasons on a case-by-case basis, and documentation stating the reason for the waiver appears in the patient's file, there should not be any problems. Deductibles and copayments should be collected at the time of service, and copayments should definitely be collected prior to being seen by the physician.
When making the appointment with the patient, it is essential to get the patient's health insurance information. At the time of scheduling, the scheduler should remind the patient that all copayments and deductibles are due at the time of service. Before the patient sees the physician, the front office should say "Mr. Smith, as you know your plan requires a copayment of $xx.xx or x%. How would you like to pay?"
One to two days prior to the patients' appointment, reminder calls should be made. The reminder should include: the date and time of the appointment, plus any copayment and/or deductibles due at the time of service. Most office visit copayments are too small to merit sending out statements. This is a very costly method of collection, especially if the patient refuse to respond or remit payment and numerous statements are sent. It is best to make every effort to collect copayments and deductibles at the time of service plus reserve sending follow-up statements (via mail) for any patient responsibility stated on the Explanation of Benefit (EOB).
If your practice is not already set-up, consider offering credit card payments to your patients (i.e., Visa, MasterCard, Amex, and Discover).