It provides an extended payment program for patients who, because of finances, have a hard time starting care or cannot choose the type or extent of care they really need or want.
There are two requirements: a) The patient must have a bank account (checking or savings) or credit card and b) You must be willing to allow the patient to pay for your services over time. A credit check is not required.
You work with patients to determine how much they can afford for a down payment and for recurring payments (weekly, bi-monthly, or monthly). Of course, it is in your interest to collect as much up front and to get the balance paid off as soon as possible. Your office has final approval. If you are satisfied with the terms, you approve them.
Yes, significantly. In almost all cases, when a patient does not start care or they choose an abbreviated treatment plan, finances are the reason. America runs on credit. When someone goes to buy a car, they rarely look at just the total price of a car. They look at how much it will cost monthly. If they can work out payments they can afford, they purchase the car. In working with thousands of offices around the country, we found the same thing to be true in healthcare. If the patient can see that the treatment or treatments fit into their monthly budget, they usually choose to get the care. This means that a high percentage of people who come into your office will choose to receive the care you recommend.
Many doctors routinely make "deals" or waive co-pays and deductibles to get insurance patients to start care. They call this a "bookkeeping discount" or "financial hardship" discount. To be compliant with insurance laws, you must collect these patient portions as dictated by the patient's contract with the insurance company. This program allows you to spread these out-of-pocket expenses out over time so virtually every patient can easily afford your care. Not only are you more compliant, but also you will collect more money.
Definitely. Your patients may know others who need your services. When patients are aware of this new payment option, they will tell more people about your office.
When you do an auto-debit program, your office is responsible for following up on any late or missed payments. A doctor's office is ranked very low on a patient's priority of bills to be paid each month. Their highest priority includes their rent or mortgage payment, car payment, utilities, food and other bills that can, if they don't pay them, have an immediate impact on their comfort and quality of life. Next comes loans to financial institutions. We fall into this category. Payments to us, a third-party company, are viewed as a higher priority than payments to your office. We want you and your staff to focus on growing your business and getting people well. We will take care of making sure you get paid.
With CareCredit, a patient has to qualify, which requires a credit check. Many patients do not qualify. If a patient does qualify, CareCredit charges your office up 13.99% of the total gross fee. This eats up a lot of your profit. Also, if the patient is late on a payment or does not pay off the amount in the allotted time, CareCredit retroactively bills them up to 29.99% compounding interest, which is not good for the patient's physical, mental or financial condition.
Yes, they still qualify for HPS. Instead of embarrassing the patient by telling them they do not qualify, just tell them they qualify for HPS. They will be grateful and be excited about working out the payments and getting started.
With CareCredit and similar programs, you pay a finance charge and in many cases the patient does also. Using HPS, you decide who pays the flat 8% processing fee. Most of our clients have the patient pay this fee, which is what we recommend since the patient is receiving a valuable benefit. Here is an example: A patient's bill is $1,200. She agrees to pay $300 today and $108 each month for nine months, of which $100 (less merchant account fees) goes to the doctor and $8 goes to HPS.
Implementation requires a few hours of training on:
- How to communicate the benefits of our program to patients so no one ever leaves your office without getting the care they need because of money: This training should be done by anyone discussing the subject of finances with patients.
- How to set up the software, described below.
- How to use the software: This is for anyone who will be enrolling people in the HPS program
Training manuals are provided for both types of training. Additionally, there are live training sessions via the internet. You get free training and support for as long as you are a client. If you need more training or have new staff to train, just give us a call or e-mail us and we will be happy to schedule them for training.
Setting up the software involves importing data such as your Charge Master (a list of the prices for all your services, goods and procedures) from your practice management software or other sources into the HPS software. You can also import your patient records, schedule, and existing patient receivables.
Carrier-specific fee schedules and past Explanation of Benefit (EOB) files are also imported so an insurance patient can be given an estimate of their out-of-pocket costs (it can only be an estimate until the insurance company has adjudicated the claim and provided an Explanation of Benefits).
Note: For an additional fee, the HPS software can be integrated to work seamlessly with nearly all practice management systems.
- Enter the patient's insurance information in the software.
- Check for eligibility. If the patient's insurance company is a member of Availity, which is the clearinghouse that is included as part of our software, information regarding eligibility, deductibles, co-pays, etc. populates the screen. If not, call the insurance company and manually enter the information into the system. Note: You can add other clearinghouses, as needed, to increase the amount of insurance information you can access in real time.
- Enter the procedures to be performed and a detailed estimate (based on carrier-specific information you imported into the software as part of the set up procedure) will be generated.
- Print the estimate and review it with the patient. Let them know this is an estimate of their insurance benefits and that if the insurance company pays more than the estimate, the system will automatically reduce the amount owed by the patient. Also, inform the patient that If the insurance company pays less than the estimate, they will be responsible for the difference.
- Determine how much the patient can pay today and how much they can pay on a weekly or monthly basis.
- Input the payment terms and patient's payment information into the payment calculator, print the care plan agreement and have the patient sign it.
- If the insurance payment is equal to or greater than estimated, the system shows a zero balance or lowers the patient's balance.
- If the insurance payment is less than estimated, the system flags the account. Call the patient to let them know there is an additional balance and get a verbal authorization to add this to the total amount owed. The software does not increase the amount paid per pay period but rather adds the balance on at the end, which increases the amount of the final payment and/or increases the total number of payments.
To automate the process, input the reimbursement rates paid by each insurance company (that you accept) for each procedure you perform. You do this by importing the Explanation of Benefits (EOB's) sent to you by each insurance company and using the data contained in them to build a database. Once you have the reimbursement rates in the system, you go through the same steps given for in-network patients except they you have to call the insurance company to verify eligibility and get information regarding deductibles, co-pays, etc.
"Self-pay" patients either don't have insurance or the insurance they do have excludes the service being provided. In other words, insurance is not part of the equation. The exact amount of the bill is known and will not change and the patient is responsible for 100% of it. For these patients, the procedure is very simple. You select the procedures to be performed, determine how much the patient can pay today and how much they can pay in recurring payments, print the agreement and have the patient sign it.
One of the reasons scheduled payments do not process is errors in account information. Another reason is a patient, in an effort to defraud a provider, provides information for an account that is no longer open. To detect such problems early and before the patient runs up a large bill, HPS charges a small set-up fee that is processed immediately. So, the first step in the collection process is to ensure that account information provided is accurate and that the patient has a valid account.
When a payment is missed due to insufficient funds or some other reason, our collections department immediately contacts the patient, identifies the problem and works out a solution (such as re-scheduling a payment after sufficient funds are in an account). This approach resolves most missed payments. The keys are (a) contacting the patient as soon as possible after a missed payment and (b) working with the patient to find a workable solution. We also have the option of collecting the amount due from alternative accounts given by a patient when they enroll in the program. Thus, it is always a good idea to get payment information for more than one account.
If we are unable to contact a patient or collect from alternative accounts, \ we send a series of letters escalating the demands for payment.
If we do not resolve the matter through the above steps, we move into "hard collections", which, depending on circumstances (including input from the provider), involve one or more of the following:
- Aggressive phone and letter campaign
- Notifying credit reporting bureaus
- Skip tracing (locating a person's whereabouts), asset investigation (in preparation for legal action), aggressive phone campaign
- Filing a lawsuit to get a legal judgment, which is used to seize assets
