Medical service providers may now require patients to pay a portion their office visit on the same day of service before billing to insurance.
I recently visited a dermatologist for my annual skin exam. I was expecting business as usual until the administrator told me that since I had a High Deductible Health Plan (HDHP) I would be required to pay 50% of the bill before leaving their office. The patient billing practice had been recently updated as of January 1, 2020.
Unfortunately, the office administrators couldn’t tell me how much the visit would cost until after their services were rendered. This means that I would be required to pay some arbitrary dollar amount the same day without the opportunity to ensure that funds were available to make that payment or even call my insurance provider.
This new billing method of collecting at the time of the office visit could put consumers in a very tough position when they visit their doctor, especially if the services needed were time sensitive like an injury or something else reactive in nature (true emergencies have to be treated by law, regardless of ability to pay). Based on comments from insurance carriers, patients may start to see this billing practice implemented more frequently.
Here’s why you may start to see this trend with healthcare providers:
The standard billing practice at most doctor’s offices is for the patient to only pay a co-pay (if required) at the time of service. The provider then bills the insurance company directly. The carrier then applies any negotiated in-network discounts and calculates what portion of the charges should be applied toward a deductible and out-of-pocket maximum. Within a reasonable amount of time, the insured (patient) and the doctor’s office will receive a billing statement detailing:
Your employees may need some advice when faced with this new billing practice. Be sure you prepare them by sharing the following tips:
Knowing there may be an increase in up-front healthcare costs, now is a great time to educate your workforce on the advantages of FSAs. Check out our e-book to get a head start.