Recently, my front desk staff asked if they could
“guest” write on MommyDoc. So with some
edits from me here are their collective words.
We often hear “I love our doctor so much, I would
not go anywhere else, but that front office is so rude asking for money when we
walk through the door.” Whether it is in
regard to a co-payment, deductible, or other outstanding balance, there seems
to be a miscommunication as to why the front feels so strongly about collecting
money owed before appointments.
We care as much about the people we see on a monthly
or yearly basis as the doctors we work for.
Revenue collection IS our job and without this, you would not receive
the personalized, in-depth care you enjoy in a small, private practice
environment. The days of physicians
driving fancy sports cars and living in mansions are long gone. Reimbursement from insurance companies has
continued a steady decline. Physicians
are now unable to support private practices without joining larger groups.
Imagine for a moment we are at a Starbucks and the physicians
are your daily coffee; you approach the counter and order your favorite drink,
Dr. Niran is a whole milk Peppermint Mocha and Dr. Saad is a sweet Vanilla
Latte. Would you order your drink and
then pay a few months down the line “if and when you have enough to cover the
bill?” Better yet as you pick up your warm drink, would you say “I am not sure
if there is money in my account, but trust me, you will get paid sometime?” Insurance companies pay claims 30-90 days
after the service, assuming we had the correct insurance information from our
patients at the time. Would Starbucks
still actually be in business if they allowed this kind of payment delay? Of course not, this is no different than
paying a co-pay each time you see your doctor.
A man called our office this week and asked what WE
charge for co-pays. What the what?
Copays and deductibles are what YOUR insurance requires you to pay according to
your contract. They consider it “your
investment” in your health care. We
were asked the other day whether the copay really makes a difference in our
bottom line. You bet it does! It makes up a significant portion of total
income for our business and keeps us afloat.
Copays pit your physician against your
pocketbook. Insurance companies want to chargeyou
$30 when you see your primary care doctor, $75 if you are seen at an urgent
care facility, and as much as $150 when you go to the ER. If an insurer “allows” $100 per visit to the
doctor, they actually pay only $65 and stick you with the other $35. So on average, your co-pay makes up 25-30% of
primary care physicians revenue. If any
business went without 25% of their revenue, they would go bankrupt.
So many insurance plans are available that
consumers must be savvy shoppers to make sure they understand exactly what
their plan is offering. People are
surprised when they pay little in monthly premiums, thinking it is a great
deal, to realize later their insurance will not pick up the tab until the beneficiary
(you) pay a substantial “out of pocket” amount, known as the deductible or
patient portion.
If you are a family with a couple of small
children who will be coming to our office at least several times per year for
well child exams, immunizations, illnesses, or injuries then a plan with a high
cost for each visit might not be the right plan for you. You might be better off with insurance and a
higher monthly premium or smaller deductible when your child is ill.
Over the past 5 years, a number of
physicians in Kitsap County have gone out of business for financial reasons, retired
much earlier than expected, have declared bankruptcy and closed, or have been
forced to join larger corporations. This
means physicians will have less time to spend with you and must increase the volume
of patients seen each day to make ends meet.
We definitely understand patients not wanting to be hassled
about payments, especially when your child is ill, but we NEED to stay in
business. This means we must collect
payments big and small. Personally, we feel
extremely uncomfortable asking people for money when they come in, knowing a
parent will protest or refuse to make a payment and demand to be seen.
The bigger picture is: unless our physicians get paid, they cannot
afford to continue as our physicians. If
we let people come in without collecting revenue owed, the likelihood of
collecting money owed drops significantly.
There are costs to mail out bills and if we begin losing more than we
take in, the staff and others employed by this practice will be out of
jobs. If our physicians are not able to
make a living, we will close. You lose
the doctor your children love so much and we lose our patients. Thank you for reading our plea. We hope you can understand. We at the front desk, look forward to seeing
you soon. #BusinessOfMedicine
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