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When you think about the complexities that employers face when they select their health plan for this year, there’s a very good chance that your patients’ benefits have changed in some way from what they were used to from last year. Add to that fact that no one really reads all the way through that nice benefits statement that human resources gives them…and then your patient appears in your office with a new problem. You might need diagnostics, or a new prescription medication, or a referral to a sub-specialist. Or maybe you are the sub-specialist. Regardless, one thing is true: your patients expect you and your team have “magical and omniscient plan knowledge” and that they expect that you’re completely dialed in to all of the nuance of their particular plan design. They expect that you are only going to order tests or write prescriptions or make referrals for things that are covered on THEIR specific plan. I know it’s not fair. I know it’s ridiculous. And, they will still have that expectation.

You may not hear the fallout from this as much as your billing team does, but if I had a nickel for every time I heard a patient say, “Well, why did the doctor order it if it wasn’t covered by my plan?” I’d be retired on a tropical island somewhere.

Join us for this episode of Medical Money Matters where we'll talk about managing the patients' part of their medical bill. We'll cover multiple strategies from check in, all the way through scripting you can use to shift the responsibility for understanding benefits back to the patient.

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