Most insurance companies now have automated fax systems that can usually provide you with this information in minutes. With a phone call, the system faxes a description of your patient`s services at your office, including deductible, surcharges, covered services and out-of-pocket limits. This extremely valuable service can make things much easier when they approach your patient through their financial responsibility. Our office keeps these faxes in the patient`s card so that they can be easily transmitted when a question arises about coverage or liability. Participating Insurance If your insurance plan is the one with which we are not a participating provider, you are responsible for the full payment. As a courtesy, however, we will present your first right to insurance and, if you are not paid within 30 days, you will be responsible. Recommendations and pre-authorizations Some health insurance (HMO, POS, etc.) require that you receive a prior referral or authorization from your primary care provider (PCP) before consulting a specialist. If your insurance company needs a recommendation and/or pre-authorization, you are responsible. If you do not receive the recommendation and/or pre-authorization, this may lead to a lower or no payment from the insurance company and the balance is your responsibility. Alternative payment terms or a rescheduling of your date may be necessary if they are not obtained. Self-pay accounts Self-pay accounts are patients without insurance coverage, patients covered by insurance plans in which our firm does not participate, or patients without an insurance card that is subject to us. Accountability and work incompatibilities are also considered self-cost accounts.
We do not accept letters from lawyers or contingency payments. It is always the responsibility of patients to know if our office is part of their plan. If there is a discrepancy with our information, the patient is considered self-payment, unless there is evidence to the contrary. A payment policy lets your patients know what you expect from them and what they can expect from you. A well-thought-out policy will prevent patients from being surprised by their financial commitment when they receive their services. There will also be some legal protection in your practice if a patient does not pay what you can move in. Choose a missed appointment/late cancellation policy. Since missed appointments and cancellations represent a lack of revenue for medical practices, many choose to charge patients for non-arrival appointments. Some also say that patients who often miss appointments may lose the chance to make new appointments at the office.
A sound financial policy can make the difference between a well-managed and successful physician who struggles to keep his doors open. Your fiscal policy should clearly show what you expect from your patients and leave no room for misunderstandings on both sides. The end result is that your office is able to collect the necessary payments, which allows you to focus on your main priority: patient care. Create a plan for all the next steps if an insurance company doesn`t pay. If a patient`s insurance does not fully or partially take care of the bill, financial responsibility is usually the responsibility of the patient. Decide how long you wait before paying through the insurance agency before charging the patient (the average time for the doctor`s office is 45 days). Partially due leftovers must also be billed to the patient, with a typical network due in 10 to 15 days.