Collecting Deductibles up front

[cdaugherty]

I've seen this posted several times but am curious...
How many offices typically collect deductibles up front?
We are a walk0in clinic that has never done this, however, new ownership wants us to do this because "everyone" he knows does. 
In our town, all of the doctors offices, that I have been to do not collect deductible up front - they actually don't always even collect co-pays.
Could anyone give me a random sampling or idea of how prevelent this is?  We do all our billing and collectiong in house but do use a collection agency for past due accounts.

Thanks,

[DMK]

With the great insurance verification websites out there you can tell if someone has met their deductible fairly easily.  You should collect deductibles whenever possible, and co-pays always.  I can't tell you how many times we end up with $0 because people don't pay their bill after the treatment.  I was trying to be kind, and it cost our office BIG TIME.  The new policy is to always collect something.  The patients also appreciate it if you qualify it with "If we collect now, you won't get a bill later".

It's a really good idea too, to make note of the allowed amount (for as many different insurances as you can) for commonly charged services so you know EXACTLY how much to charge the patient.  It makes you look more efficient too and they will believe you when you tell them how much it will be each time they come in.  People get angry when you can't give them a good idea of what it's going to cost up front.

[cdaugherty]

What websites are you using to verify?  We have found that the sites either do not give this information or it is inaccurate.  For example, I "verified" myself via our insurance carriers website.  According to the site I had $0 of my deductible.  However, what this does not tell us is that with our plan office visits are paid, less the copay, with out the deductible.

UHC seems to be the only site that would allow us to put in CPT codes, after the visit, to esitmate what to collect prior to the patient leaving the office.  This could work but is a bit awkward with the way our office is set up.

[PMRNC]

Insurance carriers can't tell you on the phone:  "Mrs. Smith has a $500 deductible, and she has $200 to meet her deductible left" The reason behind that is common sense, they don't want the doctors telling Mrs. Smith her visit is $200 or the procedure she had was $200

I tell my clients to review each one on a case-by-case basis, insurance carriers process claims in the order of which they are received, so if they have a high deductible, I have them call the patient after verification and tell them if they have their latest EOB to bring it in and show us it's been met or what's been met and we will collect the balance up to what is owed for their visit.   We don't collect the Medicare deductibles at all because 80% of the time we would end up doing patient refunds.

[Michele]

The hard part about collecting up front is that other claims may come in after you verified the deductible and that changes everything  AND  unless you are sure of the allowed amount for that carrier you may overcharge the patient.  I'm not saying don't collect, I'm just saying take these into consideration.

Copays ALWAYS ALWAYS ALWAYS should be collected at time of service unless there are extenuating circumstances.

Michele

[DMK]

All points well taken.

Anthem Blue Cross's site shows the amount of deductible, and the amount used, to the penny.  Blue Shield of California does as well.  UHC can calculate how much (approximately) they will owe.  I understand that other claims can come in, but January and February are so tight since almost everyone has a deductible, you have to get something just to keep the cash flow.

I understand not wanting to OVER collect, but at least get something so their bill won't be so huge, and so you get something if they don't pay later.  But as Michele said ALWAYS ALWAYS ALWAYS get the co-pay.