Coby Tyner has submitted another excellent essay on exploring ways to improve the patient experience at the physicians office. This time he focuses on the financial responsibility aspect of patient care. Dr. Joe Galati
I have learned a lot over the years as a healthcare administrator. And while I am not a billing expert, I do consider myself a good consumer of healthcare.
There are times that I field concerns from patients regarding bills they receive. The concerns can range anywhere from the amount of the bill itself, to why the proper insurance was not used in the submission of the original claim (and all points in between).
Now it’s true, mistakes can and do happen in the billing and collecting process. Every practice and every third party biller seeks opportunities to improve with internal processes and to minimize human errors. To complicate issues, insurance companies can often confuse patients on covered services and what’s actually required prior to receiving those services.
But there’s still hope for patients… Often times, patients can be better informed consumers of healthcare. When it comes to selecting an insurance plan that works for them and their family, covered services, and the amounts they will be required to pay (as defined by their insurance plans), they should be fully informed before the process even starts.
So let’s get down to the nitty gritty of the matter. Questions the patient should ask could include: What insurance plan fits the needs of my family? How much is the co-pay for office visits? How much is the deductible? Why should I choose a PPO plan over an HMO plan (or vice versa)? When do I need a referral? Is a pre-authorization required for procedures? Who could I talk to if I have a questions about a bill?
The takeaway from all of this is straightforward: If patients want to avoid unexpected and undesirable surprises, they should consider researching what will be required when they visit their care provider’s office – this can be done through researching the plan and asking questions to the insurance carrier they’ve chosen. The plan the patient chooses will directly drive the amounts they will be expected to pay. Also, they should actively work with their care provider’s office staff to get a clear picture on financial obligations for the practice itself (such as Co-Pays, Procedure Costs, Deductible Amounts, etc). I’d suggest working closely with the person that verifies benefits in their care provider’s office or reaching out to the practice administrator to point them in the right direction.
As a patient advocate, I want each and every patient to have a great experience when they visit their care provider; especially at Liver Specialists of Texas. Billing is an important part of the overall experience and I encourage all patients to be better consumers of healthcare – it starts with first knowing the expectations from the beginning.