Outpatient Surgery Magazine

Creative Ways to Save Money in the OR - May 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/675921

Contents of this Issue

Navigation

Page 65 of 154

owed and providing compassionate care to patients who need to undergo surgery. Here's how our business office strikes the perfect balance. Know the contracts Each member of our business office staff understands patients' insur- ance plans better than the patients themselves. We upload the terms of the contracts into our billing software, which we audit twice per year to ensure the correct payment rates are generated when we input CPT codes. We train our staff on the calculations used to determine payment rates and patients' co-pays. When we contact patients a week before sur- gery to inform them of their financial responsibilities, we can have an informed discussion about the benefits. It also helps that we assign staff certain specialties so they gain a clinical perspective. We view ourselves as benefits coordinators. Patients want to know how we calculated their deductibles, so we're prepared to go over the math with them during the insurance verification phone call. We look up the procedure's CPT code to determine our facility's contracted rate. We'll then disclose to a patient that we submit a bill for $14,000 to the insurer, which pays us $4,000. Of that $4,000, the patient might be responsible for a $2,000 deductible. Their plan might cover 80% of the remaining $2,000, so they owe an additional $400. One of 2 things will happen. The patient will tell you that he'll bring the deductible on the day of surgery or inform you that he can't afford it. Patients sometimes reveal very personal details about their finan- cial situations, so it's important for us to hear why they might not be able to afford their surgery and empathize with their predicaments. In-house payment plan We offer an in-house payment plan to patients who can't afford 6 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 6

Articles in this issue

Archives of this issue

view archives of Outpatient Surgery Magazine - Creative Ways to Save Money in the OR - May 2016 - Subscribe to Outpatient Surgery Magazine