Ask Lisa: Setting Up Finances With Your Patients

BJ Palmer had a quote: “Chiropractic is health insurance. Premiums small. Dividends large!”

Following this super quote, we have worked with offices for many years schooling them into implementing these mottos:

  • We will accept all patients, regardless of their ability to pay, but we also must operate the clinic as a proprietary business, i.e., for profit, and the patient must want the care–not just “want a discount.”
  • Each case will be individually handled and patients will receive a copy of their financial arrangements.
  • Each patient file will have a copy of the patient’s individual financial arrangements.

How does the successful office achieve these goals?

First, to comply with Centers for Medicare and Medicaid’s No Surprises Act as a covered entity, each patient will have an idea what our range of charges are and that the charges will vary depending on what is done. Explain that the adjustment charges will vary from $XX to $XX, therapies will add $XX to $XX, and exams, diagnostic tests, etc. will add to that. Typically the average office visit will be from $30.00 to $140.00 per visit. This can be shared when the new patient calls in for their first appointment, or placed on your website.

Second, determine if you will be filing claims to insurance, and if patient has a copay or deductible. If there is a financial barrier with co-pays or deductibles, work with the patient during your meeting with them so that the patient does not drop out of care for financial reasons. To stay in compliance, note any waived fees or co-payments on your financial form, indicating why they were waived (no job, too many bills). Alert payment arrangements in your practice software so that the front desk and anyone doing follow-up knows exactly what the patient has agreed to pay each visit.

The patient should already have a good idea after Day 1 from the Report of Findings and the schedule you just worked out with them how many times they will be coming in. Ask the patient if they will have any problem with this and watch the patient to make sure that they will be comfortable with the fees you are presenting (previously calculated prior to meeting with patient).

(These next sections are specific to Wisconsin offices and offer examples. However, if you find this information interesting and you want more information and are outside WI, contact us for further information.)

If you are not filing to insurance, patients are considered self-pay. Let the patient know that they must pay at the time of service for any discount given. To be successful, you cannot reduce your fee while running up patient balances.

Any discount or special fee must be noted on the financial agreements and in the computer. The financial agreement must indicate why there are special discounts given. This can be simply noted in the space provided, such as “patient discount to $30 per visit-financial hardship” or “patient has just started new job-discount given to $30 per visit”. The CA or doctor, and patient, must sign the form.

For self-pay patients who can afford care, are on a routine schedule and show up, in order to give a discount they should be required to prepay, for a package of XX visits, typically with up to a 35% discount.

With the above policies in place, you can help many more people increase their health dividends, removing any financial barriers. Implementing these steps are key to expanding and growing your practice!

If you have any questions regarding financial arrangements and/or insurance please feel free to reach out to me.

Lisa Barnett
920-334-4561
lisa@pmaworks.com

The Patient Handoff

doctor and two women introductions.

Improving your patient’s experience.

There are subtle and brief moments in your practice when you and your team can earn or lose your patient’s trust. It can make the difference between your patient agreeing to your care program or finding a reason to delay the decision.

Excuses can be easy to dream up. There are hundreds of reasons why someone can’t, or won’t, agree to a care plan or follow through with their care. But the reasons presented may not be the actual ones.

Surveys show that customers cease their relationship with a business when they experience an attitude of indifference on the part of the employee or business. People hate to be ignored.

You know this, so you ensure you and your team communicate well with patients at the front desk and during the report of findings and case presentation. These are obvious communication events.

But just as important, but not always as obvious, is the communication that occurs when the patient is transferred from one staff member to another.

This is called the Patient Handoff.

For example, the doctor has spent time reviewing the exam and imaging findings with the patient and correlated them with their history. The doctor explains the health issues and the care plan to the patient. The patient nods in agreement. With other patients now waiting to be seen and the doctor feeling rushed, the doctor may leave the patient and ask another staff member to schedule the patient for care and to work out their finances.
It would take another 3-5 minutes for the doctor to introduce the patient to another staff member and relay the key information to them in front of the patient. It would be minutes well spent.

“Hi Betty (Patient Accounts Specialist). This is Sam. He works out at the same gym as I do over at Acme Fitness. He wants to keep up with his workouts so I have worked up a treatment plan to help him recover from low back injuries. I’ve included the info in the back (hands written report to Betty). Could you schedule him for his appointments and discuss his payment options?”

“Sam, any questions or comments?”

“No.”

“Ok, great. I look forward to working with you here at the clinic and also at the gym. See you soon.”

After the report of findings is a handoff event that can be too easily cut short or skipped altogether. Another handoff I have often witnessed omitted entirely is introducing the new patient to their therapy and rehab services.

We are all in a hurry, but these patient care transition points hugely impact how your patient experiences you and your clinic.

In sum, patient handoffs help with the following:

  1. The continuity of care ensures that the patient receives consistent and appropriate care throughout their treatment plan.
  2. Minimizing misunderstandings or errors in their care.
  3. Improving your patient’s satisfaction and trust in you and your clinic.

Take time to do thorough patient handoffs, and you will see retention improve, referrals increase, and happier patients.

Working towards a healthier future,

Ed