People lose their jobs every day for a variety of reasons. As the recession takes hold, it is likely that you will be seeing an increase in the number of patients who are losing their job and the concurrent health insurance. It is likely to be for a limited period of time – a week or two……a month or two……or three……and twelve. A new job may also see a drop in income and sometimes health insurance as well.
Our focus today is not unemployment and underemployment, but rather what you should do to handle the patient who has lost their job and health insurance.
First and foremost, you should have a written financial policy. This policy, which should also be given to patients, would address such issues as whether you accept insurance assignment (including Medicare, Medicaid, worker’s comp), policies on co-payments (collect at time of service), acceptance of credit cards, and policy for hardship situations. A primary care practice is less likely to generate a large balance due from a patient than in a specialty practice.
Let’s say you have a patient of several years who comes to you with the news that they have lost their job and health insurance. Would it be unreasonable for you to start by:
? reducing your fee to the rate that their prior insurance would have paid (or Medicare is an easy benchmark), and then expect a minimum payment of $50 a month?
? Does this person need help to qualify for Medicaid (not an easy process, and often not if there are significant assets) or the SCHIP program for children?
? When writing a prescription, physicians should be mindful of the cost. Can you reasonably write a prescription for one of the generics covered under the $4 cost plans offered by Wal-mart, Target, Krogers and others?
You should be monitoring these financial arrangements on a practice wide basis, so that the delayed or written off fees are not unduly burdensome. In these situations, your objective is to work with your patient – your customer – to help them through a tough time. Many businesses do work with customers and vendors, with the idea that everyone is vulnerable to tough times, and sticking with someone in the tough times will result in loyalty and goodwill – goodwill that people do talk about.