Article

Discuss payment options

For both insured and self-paying patients, talk about finance options and do so early.

As we look to the future and rebuild practice procedures following the pandemic, financing discussions can be more important than ever.

Consider that there may be pent-up demand for services by those who have put off procedures. As such, these conversations about out-of-pocket costs are not one-size-fits-all; patients require unique information at various points during their care. Providers and staff must be ready to discuss each scenario to ensure cost conversations are effective.

Here we'll discuss how the right training and preparation will help ensure staff’s success. Specifically, we'll focus on how to communicate payment options, regardless of whether the patient has insurance, to keep accounts receivable (AR) low and provide an efficient patient experience.

Checking in

Patients’ financial situations may have changed during the pause in services resulting from the coronavirus pandemic. As such, staff members will need to check in with individuals to (1) ensure that they would like to proceed with the procedure and (2) reiterate financing options, be it insurance, out-of-pocket, or third-party financing.

Finally, the staff person will want to move to reschedule the procedure in a timeline conducive to the patient’s needs and finances and the practice’s availability.

Insurance

At Eye and LASIK Center in Greenfield, Mass., the team believes it’s in the best interest of both the patient and the practice to be clear about what the patient’s insurance plan covers and the amount for which the patient is responsible.

This discussion begins with the first phone call or consultation. Understand it can be difficult for some patients to know their out-of-pocket responsibility. For example, patients may be aware their exam is covered, but they may not realize they have a co-pay or are responsible for a percentage of the treatment or procedure. Cataract surgeries are covered by Medicare, but an upgrade to a premium IOL is an out-of-pocket expense. Practices will need to establish how the patient will pay for the premium IOL, if this is their choice of lens.

Sample script:

“[Mr./Mrs./Ms. Last Name], your doctor has recommended the following treatment ______. Based on the cost of this procedure, your insurance plan with _____ insurance, and your current benefits, we estimate your total out-of-pocket costs to be _____. Please keep in mind this is only an estimate. If you have a change in treatment, it will probably change. We think it is important to provide all of our patients with this estimate so that you are prepared for treatment costs. We accept cash, checks, and all major credit cards, as well as (mention preferred finance option or credit card, such as CareCredit).”

If patients indicate concern or inability to pay the entirety of their balance:

“Don’t worry, our goal is to work with you to find a manageable way for you to pay for your care. Let’s discuss this further to determine the best way to meet your needs.”

At this point, the most appropriate next step could include taking advantage of a payment plan, determining if the patient is eligible for insurance through other programs, such as Medicaid, or exploring other financing options.

Self-pay

When it comes to self-pay patients, transparency is key. Having discussions about costs and payment with patients up front helps reduce AR days and prevents bigger, more serious revenue cycle problems that could threaten the practice’s long-term growth and success. Therefore, the cost discussion should happen on the first phone call and be reiterated throughout the patient journey.

Sample script for initial phone call:

“[Mr./Mrs./Ms. Last Name], thank you for calling for an eye exam today. We understand that you are self-pay and the amount you owe would be $300: $225 for the eye exam and $75 for the contact lens update. How would you like to pay for this on the day of service? We accept cash, checks, and all major credit cards, as well as (mention a preferred finance option or credit card).”

Answering questions and counseling patients on their payment options are good ways to ease patients’ anxiety and increase their likelihood to pay. Timely discussions also ensure patients understand their financial obligation and providers are aware of the patient’s ability to source payment.

Patient financing

Many companies offer payment solutions easily managed in office. One such option is a healthcare credit card. This type of card can be used to pay for treatments and procedures, and it allows patients to make convenient, monthly payments while quickly providing the practice with payment for services rendered.

An effective way to implement financing is to offer it to everybody. Financing should be introduced as an option for all patients—note the mention in all scripts—and done early to provide patients with all the information to make an educated decision.

Sample script:

“[Mr./Mrs./Ms. Last Name], let’s go over the investment in your vision care. Are you aware of all the payment options available to you through our practice? We accept cash and credit cards including the CareCredit credit card, which can be used for a variety of healthcare services including LASIK, cosmetic surgery, veterinary, dentistry, hearing care, and more. I’ll be happy to assist you with any additional information.”

When the staff understands the benefits of financing, patients have the best chance of walking out with the products and services they need and want. It’s best to offer every avenue for the health of the patient.

Take-home message

By communicating costs early, asking the right questions, and showing a sincere interest in helping patients receive care, your financial conversations will be more successful with your patients. OP