The deductible game

The first few months of the year is always the most fun, as patients with deductibles will be paying more out of pocket than they will later on, as they meet their annual deductible. Ask a patient if they’ve met their deductible and most won’t be sure, and some may “lie” and say “yes” (to avoid a big payout that day). Frankly, the typical patient isn’t keeping track of where they stand where their health insurance.

Once response to a patient who isn’t sure is to ask, “who are the other physicians you’ve seen since January?” By asking for specifics, you are prompting your patient’s recall of any actual visits.

You can collect your full fee as going against the deductible. When the EOB comes back, however, if you owe the patient a refund, you need to get it out immediately. Credit balances on patient accounts should get top priority in payment, ahead of all other accounts payable, as these monies are not yours in the first place. For cash planning purposes, I would reserve some of your cash for these refunds.

If you didn’t collect the deductible at the time of service, and it turns out that the patient owes you this amount, you may want to include an insert note within the bill. Since the deductible will be a significant amount, if you don’t see payment within 30 days, these patients may warrant a polite “reminder” phone call as follow-up.

You may have to offer patients the opportunity to pay out the deductible over 2-3 months. Breaking it into $50 increments may be manageable for your patients, and may get you your money faster and with less hassle than trying to collect the entire amount at once. One option is to get authorizations for monthly credit card charges, so you can avoid the monthly billing/getting paid cycle, again avoiding time, cost and hassle for everyone, including the patient.

Deductible management is a small, but important component of cash flow in the early part of the year. By easing the collection process, you gain the cash flow with the minimum of inconvenience, cost and confusion for all concerned.