Re: Deductibles; USA only
Morris Gallo
Description
Collection
Title:
Re: Deductibles; USA only
Creator:
Morris Gallo
Date:
12/30/1999
Text:
Joe
Patients, and many providers, have incorrectly presumed that the provider has an obligation
to collect the insurance. This is not so. The patient is responsible for the bill. If they
have insurance it is a contract between the insurance company and the patient to help THEM
pay the bill. The provider is not obligated to collect from the carrier. But we both know
we providers count on the carriers for a majority of our money. Unless you had a contract
with the carrier that specified you could not collect the deductible up front they had no
right to tell the patient not to pay. Furthermore, stopping payment for services rendered
is considered illegal in most states. You may want to inquire with the local District
Attorney.
Morris Gallo
Joe wrote:
> The office in which I work has traditionally been reluctant to collect a
> patient's deductible portion of their bill at time of service. Recently
> we began collecting as more and more patients seemed to ignore the
> billing for that portion once they walked out the door. All services are
> of course prescribed by a doctor.
>
> It is only conjecture on my part but I feel that: most people are upset
> with having to pay any percentage of a bill; once the product is in hand
> and even if it helps their condition most people take a possession is
> 9/10's approach and do not feel obligated to pay; if the product does
> not help their condition most people will say why should they pay. Also
> a practitioner may elect to go easy on labor charges but products that
> we pay for must be paid for or we go out of business.
>
> Yesterday I received a Urgent authorization requiring me to fit a post
> op brace prior to surgery. I did. During the entire course of time the
> patient spent in the waiting room and during fitting, our office was on
> the phone to the insurance company verifying coverage and whether or not
> a deductible portion needed to be collected. We were told to collect.
> The patient was charged his deductible portion in which he wrote a
> check. He promptly went home and called his insurance company to
> complain about having to pay a deductible. What he was told was to
> place a stop payment on the check because we had no right to collect the
> amount until after the insurance company paid their amount.
>
> Now everybody knows that insurance companies are famous for not paying
> on time. So it could be months before the bill is collected minus the
> deductible portion. Then we must send a bill to the patient to collect
> his deductible portion. Patient has almost forgotten the surgery and no
> longer needs the brace. In his mind why should he now pay for a brace he
> doesn't wear!
>
> So my question to you out there within the USA is, how do you deal with
> deductibles?
> I say collect at time of service.
>
> Joe Harvey
>
>
Patients, and many providers, have incorrectly presumed that the provider has an obligation
to collect the insurance. This is not so. The patient is responsible for the bill. If they
have insurance it is a contract between the insurance company and the patient to help THEM
pay the bill. The provider is not obligated to collect from the carrier. But we both know
we providers count on the carriers for a majority of our money. Unless you had a contract
with the carrier that specified you could not collect the deductible up front they had no
right to tell the patient not to pay. Furthermore, stopping payment for services rendered
is considered illegal in most states. You may want to inquire with the local District
Attorney.
Morris Gallo
Joe wrote:
> The office in which I work has traditionally been reluctant to collect a
> patient's deductible portion of their bill at time of service. Recently
> we began collecting as more and more patients seemed to ignore the
> billing for that portion once they walked out the door. All services are
> of course prescribed by a doctor.
>
> It is only conjecture on my part but I feel that: most people are upset
> with having to pay any percentage of a bill; once the product is in hand
> and even if it helps their condition most people take a possession is
> 9/10's approach and do not feel obligated to pay; if the product does
> not help their condition most people will say why should they pay. Also
> a practitioner may elect to go easy on labor charges but products that
> we pay for must be paid for or we go out of business.
>
> Yesterday I received a Urgent authorization requiring me to fit a post
> op brace prior to surgery. I did. During the entire course of time the
> patient spent in the waiting room and during fitting, our office was on
> the phone to the insurance company verifying coverage and whether or not
> a deductible portion needed to be collected. We were told to collect.
> The patient was charged his deductible portion in which he wrote a
> check. He promptly went home and called his insurance company to
> complain about having to pay a deductible. What he was told was to
> place a stop payment on the check because we had no right to collect the
> amount until after the insurance company paid their amount.
>
> Now everybody knows that insurance companies are famous for not paying
> on time. So it could be months before the bill is collected minus the
> deductible portion. Then we must send a bill to the patient to collect
> his deductible portion. Patient has almost forgotten the surgery and no
> longer needs the brace. In his mind why should he now pay for a brace he
> doesn't wear!
>
> So my question to you out there within the USA is, how do you deal with
> deductibles?
> I say collect at time of service.
>
> Joe Harvey
>
>
Citation
Morris Gallo, “Re: Deductibles; USA only,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/213121.
