During medical school, doctors receive no business training. I remember learning in residency by just trying to figure things out.
Regulations, especially regarding healthcare, can be quite complex and nonintuitive at times. Some codes we were billing with just 2 weeks ago are now inactive and have been replaced. We don’t get to just tell insurance companies what we did and expect to get paid for it; we have to speak in the language of CPT and ICD10 codes. Even when we feel a level of proficiency with the coding system, insurance companies often change the rules of the game and make us give them specific codes to have services covered, but they won’t tell you which ones.
Patients with RSV—especially those who are hospitalized—face many financial costs from diagnosis to treatment. For older adults who are on a fixed income or have suboptimal insurance coverage, the financial burden can be especially difficult. As clinicians treating these patients, how can we manage the business of medicine to better serve our patients?
Hold your billing staff accountable.
If you hire someone to do a job, be sure they are doing it. Sometimes, it may not be done just because a person is unaware of how to do it.
If someone owes you money, don’t feel guilty expecting it.
Sometimes, patients are going through hardships, and it is never wrong to be compassionate. Sometimes, however, some patients just don’t want to pay.
Collect copays and deductibles up front.
This will save a lot of hassle, including sending statements and making phone calls to patients who are past due.
Keep financial matters out of the patient’s room.
Inside the patient’s room, we should only discuss the patient’s healthcare needs. Addressing financial issues with patients in the exam room can sour the doctor-patient relationship.
Help the patient understand their coverage.
Remind patients that the amount they are required to pay for every visit, test, procedure, and treatment is due to a contract signed between them and the insurance company. The doctor is not the one who determines any of these costs. Cover anticipated costs associated with diagnosis and treatment upfront.
