Upfront Collection of Coinsurance

Has anyone had experience and/or success with the upfront collection of patient coinsurances? We currently collect co-pays and deductibles upfront and are exploring whether we could do the same with coinsurance amounts.

Started by: Ryan Miller (Administrator/Director/Manager/Owner/Exec. Officer) at December 2, 2011 (11:16 am)

Comments and Responses

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We have always collected coinsurance up front. Our reception/billing staff are typically able to verify benefits on each patient, and we call those who will owe about 1 week ahead. It is the facility's written policy that co-ins and co-payments are due at time of service. With advance notice to our patients we generally do not have any issues collecting upfront. I also would agree with one of the other posts, it can be difficult to collect once patients have left the facility. For patients with extremely large deductibles or self-pay we require a deposit at time of service.

Jenai Christensen (Other) at December 6, 2011 (11:14 am)

Let me offer a different perspective - both as a responsible and paying patient, as well as being in an anesthesia group that gets ZERO up front payments from any patient for anything - demanding payment up front irritates the heck out of me.

As a patient, I try to avoid paying any amount up front whenever possible. Why? The data available to your financial people from insurance companies is frequently not up to date with respect to amounts of copays, deductibles, and out-of-pocket expenses already paid. I have gone in for procedures knowing that I have already met my out of pocket expenses for the year, and the facility still wants money up front. And despite at least one poster indicating "we try to be prompt with refunds when overpayments occur", I have found that is definitely the exception rather than the rule. And let's be honest - if you are collecting too much up front, it simply proves my point that the data you're using in calculating up-front payments is flawed.

John K. (Other) at December 6, 2011 (10:32 am)

We do collect and have for the past six years. This is a business not a bank. Deductibles and co-pays are due at or before the day of service. You should use the old adage from a Little Rascals episode in the 1950's to wit: "No tickee, No washee."

We do elective surgery not emergent surgery. Patients can have the surgery later if necessary. You also need to have a Promissory Note that patients can sign at your discretion if they cannot pay the entire portion due prior to surgery. We have had less than 3% of our patients default on paying after they sign the Promissory Note as long as they have paid something "up front."

S. Katz (Administrator/Director/Manager/Owner/Exec. Officer) at December 6, 2011 (8:40 am)

We collect copays, deductibles, and co-insurance fees on DOS. We have an insurance clerk who calls patients informing them of the amounts and requesting payment on the DOS. We do occasionally have to refund when an overpayment happens.

Lorraine G. (Administrator/Director/Manager/Owner/Exec. Officer) at December 6, 2011 (8:25 am)

We collect copays or a deposit based on the patient's deductible upon checkin on the date of surgery. We also have two staff members who call the patients in advance to let them know what their copay or deposit will be.

Becky Simpkins (Other) at December 6, 2011 (8:09 am)

This is an effort we just began. With growing aging A/R due to the "self-pay" portion of our collections, it seems like a must. I'm hoping that it will have a positive effect. Most people today (due to the economy), it seems, are content with simply going to collections and taking a credit hit. I hate to do that, but we as a business have to stay afloat, as well. I'm interested to see the different responses from others who have this process in place already... would really like to see the problem areas that arise and where it needs to be tweaked.

Jonathan jernigan (Administrator/Director/Manager/Owner/Executive Officer) at December 6, 2011 (8:03 am)

We have one staff member who's main job is to verify benefits and quote them to the patient. We routinely collect coinsurance amounts as well as deductibles and copays. You must have accurate fee schedules from all your contracted insurance companies in order to do this. I update a spreadsheet yearly so that we can be as accurate as possible. We also try to be prompt with refunds when overpayments occur.

Leah Chandler (Other) at December 6, 2011 (7:13 am)

We have been collecting co-pays and deductibles at the time of registartion for years. I hate to thin of what our A/R would be if we didn't. Once these patients leave our center that chance of collecting money decreases dramatically.

Andrea Hyatt (Administrator/Director/Manager/Owner/Exec. Officer) at December 6, 2011 (7:05 am)

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