iPatientCare Blog - Patient Estimation

Estimate Patient Expected Out-of-Pocket Responsibility

It’s nearly 75% of provider organizations’ bad debt is reported from outstanding patient balances. Thanks to the Affordable Care Act plans high deductibles and larger co-pays continue to soar in patient financial responsibilities.

Ground Reality: A larger portion of patients walks out of the provider’s office without paying a dime. This trend is soaring on the higher side because of the inability to determine what you can collect. Co-payments are a given sure shot, but will your payer contracts allow you to capture coinsurance and unmet deductibles?

To handle these un-toward incidents update practice policy to collect these monies at the time of service and require patients to sign such financial agreement forms.

Correct Approach: Time-of-Service collection(s) starts right before the patient even arrives at the provider’s office. When patients call for appointments, set and establish the right expectations and make them aware of their current standings by reviewing the account ledger. Give a gentle reminder of your policy by saying: “We do expect payment at the time of service, Ms. Gomez.” and/or saying “Ms. Gomez, I notice that you have a balance.”

Automation Tool: iPatientCare Patient Payment Estimation is a contract-based advanced estimation tool with the ability to produce estimates of patients’ medical costs. Patient Payment Estimator allows your staff to give patients written estimates of their expected out-of-pocket responsibility after payment by their insurance carrier based on their plan coverage.

iPatientCare Patient Payment Estimator analyzer shares the provider’s negotiated contractual reimbursements; the historical, procedural information along with the charge description master information; and patient-specific, year-to-date benefit data to arrive at the most credibly defensible estimates of the patient’s out-of-pocket financial responsibility.


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