Co-Payments Can Make or Break Your Practice Today

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If you are an independent medical practice, your staff may be leaving a lot of your hard-earned money on the table.

Patients will claim they do not know what their current co-payment is or their insurance card is correct. Always make your staff verify the true co-payment amount.  Nowadays, there are tiers of co-payments for Primary Care doctors or for specialists.   Every plan is different and sets its co-payments by the premiums paid by the subscribers or employers. The lower premiums the higher the co-payments.  This is true for every insurance company.

Before the ACA came along, co-payments started at $5 or $10 and were already inching up slowly but surely.  In the beginning, co-payments only comprised up to 10 percent of the reimbursement for an office visit.  Fast-forward to the present, it is not unusual anymore for co-payments to be as much as 30% or more.  At $65 to $75 co-payment per visit, if uncollected, it means lower physician take-home income for you after your costs.

In our experience, your staff can leave money on the table 90% of the time by not collecting the entire co-pay amount up-front due to you and your practice.  Your loss in income may be compounded by the extra cost to bill your patients not only once but, more likely, multiple times, all to no avail because patients have no sense of urgency to pay you after they have seen you.   The front desk must make the effort to collect the co-payments up-front or, if not, the unpaid balances sooner rather than later when the patients come back and need you to treat them again.  Think about it: what other business allows its clients or customers to walk away without paying for services or products rendered.  Don’t be that kin of business.

You can fix this by calling CPM.

It is never too late to do the right thing and do things right for yourself and for your practice.

Taking care of your business always,

Peter Melencio, CPA

December, 2018

CPM – The Doctor’s Business Doctor – Medical Billing your way – the only way!

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