Sunday, February 1, 2009
Seeing the Doctor? Bring your Credit Card
The days of the $5 or $10 copay are leaving fast. A growing number of doctors offices are now using software programs that can tell them exactly if a deductible has been paid and what the patient needs to pay at the time of the visit. Most insurance now has a large deductible..even as much as $2500 to $5000 a year. Many healthy patients don't even meet their deductible in a year so they are responsible for first dollar payment.
From the doctor's perspective, collecting this money at the time of service is good business sense. The good old days where the doctor was paid last, is long gone with primary care and even general surgery doctors closing their doors because of financial issues. The margins are very thin in many medical offices and as practice expenses rise, the need to collect at the time of service is critical.
"Bill my insurance" is a term that is going by the wayside. Since "Bill my insurance" actually means the doctor will send several bills over several months and maybe 4 months later will receive a statement from the insurance company that says the amount billed is $135...the amount allowed is $62...and the patient has not yet completed the deductible so the payment is $0.
It costs a medical practice between 6-10% to send bills. The practice has just lost money on seeing that patient and in some practices 30% go unpaid.
It is no wonder physicians are being forced to be more businesslike and collect at the time of service. But it is painful for patients who have always layed down a $5 bill and they think this is the cost of medical care.
When patients pay out of pocket they do become better at deciding if they really need that test. They also realize up front what a rip off their insurance is. (don't get me started on the health insurance biz). I've said before that most "screening" blood tests are wasteful. Patients are now finding out just how expensive they are too, as they pay a larger part of the actual cost of care.
Now we need to get to the place where patients can find out AHEAD of time what the cost will be. You wouldn't dine in a restaurant without knowing the menu price. Patients shouldn't be forced to receive medical service or tests without knowing the menu price either. That would be one way to bring costs into line.
Posted by Toni Brayer, MD at 9:49 AM