Working with and for patients
The business office is focused on helping patients navigate their insur-
ance plans. "We all know that these times are difficult for both patients
and centers," says Joyce Mackler, RN, MSN, CASC, the center's manager.
"Patients have large deductibles that they're neither aware of nor under-
stand."
To give patients more insight to their benefits, the center created an
insurance glossary on its website (osmag.net/cZzBB5). The site also
explains the center's policy for collecting patient responsibilities: All
co-payments, co-insurances and deductibles are collected upfront at
the time of service.
Part of what makes this possible is the center's staff, says Ms.
Mackler. She credits the front-office receptionist, Rose Hastings, and
the accounts manager, Robin Church, for educating patients on their
responsibilities before they arrive for their endoscopies. "Between
Robin and Rose, we contact every patient ahead of time in writing or
by phone to explain the expected cost, insurance payment and patient
responsibility," says Ms. Mackler. Ms. Hastings calls the center's
Medicare patients to remind them of their co-insurance and
deductibles.
The staff also verifies the insurance information that dictates these
out-of-pocket patient costs. "While online insurance verification and
coverage information is helpful, sometimes the best source of informa-
tion comes from making a phone call to the insurance company," adds
Ms. Mackler.
If staff contacts a patient and he says that he can't pay his full respon-
sibility, the center is happy to work with him on a payment plan. The
plan typically consists of 50% of the total cost due at the time of service,
with the balance due over the next 3 months, says Ms. Mackler. These
S E P T E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 1
