Is anyone aware of such a software which can give us pre estimate for patient deductible and out of pocket responsibility based on CPT code?
From doing some google searches I came across a software based overseas I believe does real-time eligibility and verification benefits www.intake.io it looks like a standalone and has place for patient to enter demographics from an Ipad. NOW.. as far as collecting BEFORE the visit.. I have a problem with this and I believe you could easily make a case out of it. Most insurance polices have their cost provisions in their summary benefit plan book that will specifically say "at time of visit". Same with physician contracts with carriers and I'd be sure to bet taking copay before a visit would in fact violate some of those contracts. I personally would NEVER pay my copay until checkout. I took my daughter to a dermatologist (only one in a 100 mile radius) who wanted our copay and deductible up front. I had no choice, I paid it and then we sat in the office for 3 HOURS to see the doctor.. I went up to the desk and told them I wanted my check back or I'd walk out and go straight to the bank and stop payment. She handed me back the check and said she would have to re-schedule the visit. upon talking to other patients in the wait area, this doctor does that because he can because he's only dermatologist in a 100 mile radius.. well that's ok, not THIS patient. Ended up going to another state to see a doctor. From my point of view that doctor owed ME money for sitting there for 3 hours!
I was surprised and asked to frond desk rep that how did they figured out that what level of services will be billed to insurance without even seeing the doctor. She said based on the problems I told over the phone at time of appointment, Dr. has predetermined the level of services.
As for what the insurance rep told you, do you think maybe they were confused by what was being collected before the services were rendered? A co-pay is one thing, but a level of service allowed amount is something else.
This is just wrong, wrong, wrong. I would never see a doctor who does this. If they are doing something like this, I wouldn't want to know what else they are doing that is wrong. I couldn't trust an office/doctor with that kind of policy in place. As for what the insurance rep told you, do you think maybe they were confused by what was being collected before the services were rendered? A co-pay is one thing, but a level of service allowed amount is something else.