A patient comes into your office. Your front desk staff verifies their insurance and then sends them back for their appointment. A few weeks later, the patient receives their bill and calls your office furious. Their financial responsibility has come as a complete shock. If this series of events sounds unpleasantly familiar, you’re not alone. Most patients don’t fully understand their insurance coverage. Fortunately, there is a solution. Providing clear insurance benefits education is key to a great patient experience.
At RevWerx, we are committed to helping your practice thrive through excellent billing management. Maintain and improve your good reputation with patients by calling us today. We’re standing by to help your staff learn to explain insurance benefits to patients clearly. This will help avoid negative interactions related to billing and create a great patient experience. Contact us online or call 833.309.0138.
Why Help Patients Understand Their Insurance Coverage?
Although it is patients’ responsibility to understand their insurance, it is in your best interest as a provider to assist them. A patient who trusts that you will help them understand their bill is a patient more likely to return in the future. On the other hand, an uninformed or misinformed patient who is surprised by their bill is likely to look for another provider in the future. Here are a few other things you’ll avoid by providing healthcare insurance education upfront:
- Delinquent accounts: Patients who don’t fully understand their insurance coverage may not pay their bills. This could be because of unwillingness or lack of financial resources. Whatever the reason, delinquent accounts reflect poorly on your business and damage your revenues.
- Unhappy patients: Patients surprised and upset by their bills are unlikely to recommend you to others. They are, in fact, likely to speak poorly about your practice to friends and loved ones. It’s important to realize that patients are in a difficult situation too. The insurance landscape is constantly changing, and it’s easy to miss updates about small but significant shifts that occur in coverage from year to year.
- Unhappy staff: Your staff is likely to be unhappy if patients frequently take out their frustration on them. Avoid this by making costs clear to patients upfront and helping patients understand what their insurance does and does not cover.
How to Break Down Key Healthcare Insurance Concepts
Your patients will have varying levels of understanding of their health insurance plans. For this reason, it’s a good idea to be sensitive in explaining benefits and billing. Do so before the patient receives any services, but allow them to set the pace for how much detail you cover. There are many terms that a patient should know. Nothing is better than a friendly face-to-face conversation with one of your staff to ensure they have the insurance literacy needed to understand their bill. The person who delivers this service should be personable, respectful, and able to accurately gauge how much explanation each patient needs.
Here are a few key insurance terms that every patient should understand:
- Deductible: The amount that patients must pay within a designated time for medical services before insurance plans begin covering any costs.
- Premium: The cost of the insurance plan itself, which usually appears as a monthly charge. This could be paid by the patient, their employer, their union, or a combination of entities. Plans with higher deductibles usually feature lower premiums. Similarly, plans with lower deductibles usually feature higher premiums.
- Coinsurance: The percentage of a medical bill patients are responsible for paying after hospitalization or similar treatments once their deductible is met.
- Copay: Fee that is due upfront for healthcare treatment or service.
- In-network vs. out-of-network: A provider is “in-network” for a patient if they’ve made an agreement with the patient’s insurance company to accept a predetermined amount for a particular treatment. A provider who is “out-of-network” for a patient has not made a contract with their insurance company and can bill the client what they believe individual services are worth.
Partner with RevWerx Today to Provide Great Insurance Education to Your Patients
A positive patient experience starts with clear communication about cost. That’s why it’s essential to provide an explanation of benefits to each and every patient who comes through your door. At RevWerx, we’re here to help your staff get ready for this important work. Reach out online or call 833.309.0138.