Archive March 2017 XVIII, No. 3

Ideas That Work: Clearing Confusion Over Covered vs. Non-covered Services

what patients owe for non-covered services GOT YOU COVERED The letter breaks down what patients owe for non-covered services and reminds them that they're responsible to pay for a portion of covered services.

Clearing Confusion Over Covered vs. Non-covered Services

It's easy for patients to get confused when you try to collect fees for non-covered and covered services. Wait a minute, if they're covered services, aren't they covered? Well, yes, they are, but they don't cover what your contract with your insurance company requires you to pay for covered services: your copay, deductible and coinsurance.

It gets more confusing when surgeons offer patients femtosecond laser surgery and a premium intraocular lens for, let's say, $3,000 out of pocket, and tell them that "everything else is covered." Not exactly. Patients are still responsible to pay the facility for covered services. In addition to having surgeons complete this letter and give it to their patients when they are booked, we notify patients of the amount due at check-in 72 hours in advance of their surgery.

Kelly A. Fitzpatrick, RN, BSN, MBA
Garden City (N.Y.) SurgiCenter
(Northwell Health)

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