How to Adjust Collection Strategies to High Deductible Health Insurance Plans


High deductible health insurance plans, or HDHPs, have become increasingly popular over the past decade.  While many consumers search for ways to save some tax dollars and cover their regular monthly expenses with healthcare that tends to cost less per paycheck, healthcare providers have been forced to explore creative new ways to collect payment from their HDHP patients.  Popularity has grown so much, in fact, that the CDC reported, "In the first 3 months of 2013, 32.5% of persons under age 65 with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP)."  In other words, you may be missing the mark on one-third of your revenue if your collection strategies don't align with the special circumstances that often surround high deductible health care plans. If you're struggling to find strategies that appropriately address your collection needs as they relate to HDHP-carrying patients, consider the following options:

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Increase Patient Education

Long before you get to the point of trying to collect payments, your patients should have an in-depth understanding of what's to come.  With today's transparency and technology, it's possible that most people who enter your establishment will have self-educated themselves on the ins and outs of the procedure at hand and the costs associated with it.

If you want to increase your odds of receiving payments from your HDHP patients, it's up to you to educate them about the way the plan works and the potential invoices that could be presented to them, should the insurance company deny to cover or reduce the costs of the procedures.  

Think of this as patient-friendly pre-billing.  When your patients give the go-ahead with all of the information on the table, you're far more likely to receive payments when the bills start rolling in.

Investigate and Perform Proactive Detective Work

Another aspect of pre-bill preparation comes in the form of great detective work.  With an investigative team on your side, your revenue cycle management staff members will have an easier time obtaining and explaining payments to patients.  Investigatory procedures are particularly helpful for elective procedures where patients may not realize the ultimate financial impact of their decisions.  

Once an elective procedure has been scheduled, your investigative team should contact the patient's insurance provider to ensure the policy is active, the procedures are authorized, and to determine essential elements such as deductibles, copays, and coinsurance.  During the phone call in which the patient is reminded of his or her appointment, the team member can then remind the individual of his or her financial obligations.  Have scripts available to avoid awkward conversations and help ensure staffers are as prepared as possible.

Proactively Navigate Obstacles

Prior to or at the time of visit, you should be able to assess whether or not the patient will be able to pay the deductible.  Patients who will be unable to pay should be presented with options at this point.  For patients who may be unable to pay as a result of a temporary setback, consider offering a deposit option.  For permanent payment obstacles, consider suggesting charity-funded payment options.

As the healthcare industry continues to evolve and change in the midst of policy and economic ebbs and flows, HDHPs will likely remain a relevant part of the revenue cycle management process for years to come.  If your practice has successfully adapted to the changing landscape of HDHP payments, we'd love to hear your tips and stories!  Please feel free to comment below or contact us.