Insurance Exchanges and Your Practice: 5 Collection Tips

February 2, 2015

Many of the health insurance exchange plans include high deductibles, so getting these patients to pay their portion of your fee is critical.

If your practice is participating in any of the plans offered through the health insurance exchanges, it's time to step up your patient collection efforts. Many of the plans include high deductibles, and as a result, your patients are shouldering more of their healthcare costs.

Here are five ways to ensure that these plans don't negatively affect your practice:

1. Do your homework. When new patients schedule appointments, check with their insurance company to determine what sort of deductible they have prior to visits. That way your staff members will be ready to collect accordingly at the time of the visit, says Mary Witt, senior vice president of healthcare consulting company The Camden Group.

2. Inform the patient. When you find that patients will shoulder significant costs, let them know prior to appointments so that they are more prepared to pay. "... Remind them they have a copay, that they have a high deductible, and let them know what your expectations are around payment," says Witt.

3. Collect at time of service. Tell all of your patients that they will need to pay copays and past due balances at time of service, says Witt. "It's always easier and less expensive to collect that payment when the patient is there, than to try to collect it after that service has been provided."

4. Educate patients. Make sure your staff members are prepared to explain how insurance works to patients, says practice consultant Owen Dahl, of Owen Dahl consulting. "The practice needs to train its employees so that the employees have a skill-set of not only recognizing the type of plan that the patient has, but then having the ability to communicate that," he says.

5. Plan for additional staff time. If many of your patients are newly insured, your staff will need to spend more time educating them, fielding questions, and attempting to collect, says Dahl. Make sure you consider those new time constraints when creating your schedules and determining your staffing mix.