We've talked a little bit about this topic before (see our previous blogs and videos) and we believe it's a key concept for doctors when it comes to increasing their own compensation as well as improving their doctor-patient relationships and overall patient satisfaction. 

The concept: Doctors must help their patients not only navigate the medical aspect of their care, but the financial aspect as well.

Here's why:

Before the era of high deductible PPO's, it was a common practice for a physician (or medical group) to bill the patient's insurance and then wait for the check to come in from insurance. But in today's health insurance climate, it is very likely that insured patients are still personally liable for some or all of your charges because it is still within the limits of their deductibles.  

But your insured patients might not really know or understand that, and that's where confusion sets in.

Most patients firmly believe once they have insurance that they are "covered". Very few bother to read the fine print and fully understand what their responsibilities are when it comes to paying for healthcare.  And when they finally see the bill, they get upset and angry and they blame....you, the doctor.  Because, after all, it's the doctor that's charging them, and it's the doctor that they now have to pay something they thought was already covered. 

They are obviously wrong, but can you really blame them? 

Insurance companies are not exactly transparent and overly upfront about the true cost of care.  When was the last time you saw an insurance card that says in bold letters in 14-point font, "You will have to pay the first $3,000 of all of your medical bills."  A clear statement like that could not really be missed or taken the wrong way.  What CAN be taken the wrong way is the $10 co-pay on the front of the card.  And that is all your patient sees. 

Is there anything YOU can do?  Absolutely.

You can and should help your patients understand what exactly their health insurance plan is.  It is no longer enough for them to say, "I have Anthem" and expect everything to be covered.  If someone asks you what kind of car you have and you say "I drive a Ford", what does it mean? Well, not much.  Is it a Focus, a Mustang, or an Explorer?   And if it's a Focus, what trim level, what engine, what features?  It's not any different when it comes to health coverage.  In addition to helping your patient's understand their medical care, help your patients also understand the financial part of their care - that it is their responsibility to know EXACTLY what their co-pays, deductibles, co-insurances, and in-network providers are.  If someone has a high, let's say $5,000 deductible, be upfront with them and tell them that they will likely get a bill that will be "covered" by insurance but that, due to their high deductible, THEY will be responsible for the covered portion.  

When patients are fully informed about their financial obligations BEFORE they are charged, they feel better about their care. When they feel better about their care, they are less likely to dispute your charges and are more likely to pay them in full, which saves you the hassle and the lost revenue and time of patients disputing your charges and their liability to pay them. So, by informing your patients about their individual financial liabilities you are not only giving them a better experience, you are also increasing your take home pay, too.

Medicine is now a very big, expensive, and somewhat broken ship.  Since the physician is the captain here, it is no longer OK to plead ignorance or hide behind the old notion that "doctors need to do doctor's job and administrators will do theirs". To help your patients achieve well being, physicians need to fully understand business side of things and be able to communicate it, too.

But you might already have enough on your plate with the medical aspect of a patient's care - where would you even start with the business side of it all? 

Here's what we propose: During your next consultation, try to take an extra minute to encourage your patient to study and understand their insurance plan, and answer any questions they might have about it.

Open these dialogues with all of your patients, and we promise, you'll be surprised with how well it is going to be received!

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