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SIMPLE One-Page Financial Policy
Explaining fees to patients is a complex subject with many variables such as co-pays, deductibles, co-insurance, non-covered services, and limitations on policies. Having a simple financial policy allows you to comply with regulations, easily explain fees to patients, and stop playing “let’s make a deal.” This is one of the most requested resources we offer. DOWNLOAD BELOW
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Thanks for your interest in our One-Page Simple Financial Policy. This is one of the most requested resources we’ve offered and for good reason. Clinics have asked for a simple way to explain fees. The reality is, it’s a complex subject with so many variables such as copays, deductibles, and non-covered services. This simple policy makes it clear that YOU are doing your best to comply with the various rules and regulations we face as health care providers, such as your provider agreements and billing and coding guidelines.
This One-Page Simple Financial Policy is the result of years of effort to simplify our own financial policy in my office. To make it work in your office, you need to make sure that you have taken all the right steps to make it successful.
First, You should establish your ACTUAL fee. This means you have made the decision to have ONE fee that you charge EVERYONE for each service you provide. However, there is a difference in what we charge and what may be allowed by our various provider agreements and by some payers such as Medicare. Once you have established your ACTUAL fee, then the only time you should offer a discount is in accordance with this policy.
Second, Consider joining a Discount Medical Plan Organization or DMPO. As a member of a DMPO, you minimize the risk to your practice while setting yourself up for success by being able to offer legal network-based discounts. This model makes it easy to convert shopper calls into new patients, transition insurance patients to private pay, and offer family plans as well as helping patients deal with high deductibles and copayments.
If you do not join a DMPO, then you should keep any discounts you offer in line with your ACTUAL cost of doing billing. That range has been reported to be at 5-20% by most consultants. And, please understand that you shouldn’t offer discounts on deductibles and copayments under most health plans.
Once you have established your policy, make sure you conduct a FINANCIAL REPORT OF FINDINGS with each patient. As doctors, we understand the importance of a solid Clinical Report of Findings. But our patients make decisions based on clinical AND financial factors. And most complaints to our boards of examiners are not over our clinical care but over our financial policies. This simple document makes your financial policy clear to patients, so please have that conversation up front.
Take a look at your financial policies and make sure you are limiting your exposure to the risks of complaints, audits, fines and penalties. Download our free forms designed to help you protect and grow your practice. For more information on how to best implement this policy, contact us today about becoming a provider with ChiroHealthUSA.
CHARGE ONE FEE: YOUR ACTUAL FEE.
Use a DMPO to…
- convert shopper calls.
- transition patients to private pay.
- keep Medicare patients in treatment.
- see more families.
Reduce fees ONLY…
- as a participating provider in a health plan.
- for mandated State & Federal programs.
- when participating in a DMPO.
- when hardship conditions are met.
Offer Prompt Payment Discounts…
- only where permitted.
- reflecting only your actual billing costs.
- but not for federally insured patients.
Conduct a Financial Reports of Findings.
- Get the money part out of the way.
- Be clear about fees.
- Be consistent.