Message to Patients and Medical Practitioners alike:
In case you haven’t noticed, the health care reimbursement world has REALLY changed! What changes do you need to make to best utilize the current system?
As a patient, it used to be that you just needed to arm yourself with medical related questions when you prepared to see a medical practitioner. Today, you almost need to treat it more like a meeting with your accountant, attorney and financial planner in addition to your medical care provider.
As a medical practitioner, you used to bone up on your diagnostic skills, make sure you were up to date on the most current treatment modalities, and sharpen your bedside manner. Today, you need to concern yourself with liability worries, getting paid for your services - and keeping those payments, prescription drug seeking patients, and complex ever-changing insurance payment rules, just to name a few.
So what to do?
Patients, familiarize yourself with your insurance plans. If you’ve got a high deductible plan, be prepared to pay for services until your deductible is met. Chances are you selected that plan to save some money on your insurance premiums, but don’t think you’re not going to pay one way or the other! Understand how in-network and out-of-network benefits work. The insurance companies are enforcing the rules these days, so while your medical practitioner may have been able to ‘forgive’ certain patient responsibilities in the past, it’s one of the things that has changed!
Medical practitioners, like it or not, your practice will benefit from adopting a customer service mentality. Understand that your patients may be as baffled by the complex insurance rules as you are. Your staff should be prepared to explain the details of how their individual care is expected to work with their insurance and what their responsibilities will be. Your staff will also need to be equipped to stay one step ahead of the insurance companies. Unfortunately, our system is set up on a profit based model and profits are maximized when payments are reduced or denied, and you will have to be very proactive to ensure you get what you’re entitled to.
If you’ve got any health care reimbursement questions or topics you would like to know more about, email me at Sue@HabaneroInc.com.