Patients expecting steeper discounts
Be diplomatic in your response
Patients with large deductibles often feel patient access staff members are unreasonable to ask for the amount upfront, but what about the other side of the coin?
"If patients were denied coverage or services, we charge them the lesser of our contracted rate or the self-pay discount of 45%" says Stephen Hovan, vice president of revenue cycle at The University of Tennessee Medical Center in Knoxville. "We offer patients who pay their out-of-pocket amounts upfront a 10% discount."
Some underinsured patients are asking for additional discounts from the contracted rate, reports Hovan. If a patient has a $10,000 deductible for example, and is charged $5,000 for a positron emission tomography (PET) scan, and the contracted amount is $1,000, the $1,000 is normally directly billed to the patient. "But the patient wants a deal. So in some cases, we are further discounting the amount from what the payer would have paid us," Hovan says.
Robb Wilburn, director of patient registration at Sarasota (FL) Memorial Health Care System, says, "Patients are asking for larger and larger discounts. We stick to our current policy. The largest discount we can offer is a 60% prompt pay discount."
For patient with large deductibles, if their deductible is greater than the procedure, registrars ask for full charges. If the deductible is less than the total cost of the procedure, registrars allow patients to make a deposit. "In some cases, we have allowed patients to make payment arrangements on the deductible, but we do not discount their deductible," Wilburn says.
Registrars inform the patient of the discount they're getting before their arrival. "This seems to help ease the blow. Our staff is trained to be as compassionate as possible on this matter," Wilburn says. "We explain to the patient that this is a contractual agreement between them and their insurance company."
Linaka Kain, DE, a Medicaid specialist at Trinity Regional Health System, Rock Island, IL, is seeing more patients who are employed and have insurance that ask about charity care and are over income to qualify. Kain tells these patients that unfortunately, they do not meet the criteria for assistance as they are not indigent, homeless or living below the poverty guidelines.
"When they hear some of these words, it reminds them of what other people do not have and how fortunate they are," she says. "They are then not upset that they do not qualify."
Patients are offered a 20% discount if they pay their bill in full. "That seems to satisfy a lot of the population that have the money to do so," says Kain.
Sources
For more information on discounts offered to self-pay patients, contact:
Stephen Hovan, Vice President, Revenue Cycle, at The University of Tennessee Medical Center, Knoxville. Phone: (865) 251-4534. Email: [email protected].
Linaka Kain, DE, Medicaid Specialist, Trinity Regional Health System, Rock Island, IL, Campus. Phone: (309) 779-2648. Email: [email protected].
Robb Wilburn, Director, Patient Registration, Sarasota (FL) Memorial Health Care System. Phone: (941) 917-2366. Email: [email protected].
Patients with large deductibles often feel patient access staff members are unreasonable to ask for the amount upfront, but what about the other side of the coin?You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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