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Large out-of-pocket? Offer patients options
Come up with a solution
At Fairview Northland Health Services in Princeton, MN, when patients learn they will have a large out-of-pocket responsibility, patient access staff work with them to explain their payment options, says Steph Collins, manager of patient access.
"Within the last six months, we started using a new tool that helps us set up monthly payment plans using patient's credit or debit cards," she reports.
Patients are able to have a prearranged amount paid to their medical account each month through their credit card, or their checking or savings account, explains Collins. "This is new for our patients," she says. "Many have commented on how much they appreciate it. They no longer have to remember to send in their monthly payment for their medical bills."
Staff also screen patients to determine if they are eligible for the hospital's charity care program, says Collins. Staff refer patients to their employer or insurance agent if they think the information is incorrect, she adds. "Most importantly, we let the patient know we're here to help," says Collins. "Most of the time, we can work with the patient to come up with a solution that meets their needs and expectations."
Angela Cabarteja, supervisor in patient financial services at Virginia Mason Medical Center in Seattle, says that her patient access staff have "a lot of financial options" to offer. For instance, staff can provide a screening for the state Department of Social and Health Services and offer assistance completing an application, she says. Staff can offer patients varying levels of charity based on the federal poverty guidelines and the patient's income, or payment arrangements can be made, says Cabarteja. "We try to identify these concerns prior to the patient having a service, so we can eliminate the guesswork," she says.
If a patient qualifies for charity upfront, she explains, the patient knows he or she won't have a balance after insurance. "This puts the patient at ease, so they can focus on their care and recuperation," she says.
At Moses Cone Health System in Greensboro, NC, financial counselors try to interview every self-pay inpatient while they are still in-house, to screen them for possible Medicaid eligibility as well as state and local programs, says Todd Shoaf, director of patient accounting.
"We average about $1.3 million in conversions weekly," he reports. "We routinely convert many accounts weekly from self pay to some type of sponsorship."
Staff members ask patients questions based on what the state Department of Social Services (DSS) will be looking for and review their medical records for possible long-term disability, says Shoaf. "If we feel Medicaid is an option, we schedule an appointment for the patient with a local DSS representative located onsite in the hospital to fill out a Medicaid application," he says.
Patients complete the application while they are still in the hospital, says Shoaf, and the financial counseling staff follows the case with DSS to find out where they are in the approval process, until a decision has been made. "Additional medical information or information from the patient may be needed," he says.
If the patient ultimately is approved, this approval benefits the hospital and the patient, says Shoaf. "The patient doesn't have to worry about how they're going to pay their bill, and the hospital receives some reimbursement for the services provided," he says.