How to Handle Self-Pay Patients

How to Handle Self-Pay Patients

Even with the advent of the Affordable Care Act, not everyone has insurance — either they can’t afford to purchase a plan through the healthcare marketplace or, in states like Florida that didn’t expand their Medicaid program, they fall through the cracks and don’t qualify for the income-based program.

Self-pay patients are becoming more and more common, but many have trouble finding a primary care provider because so few doctors accept self-pay patients.

Here are some facts, tips, and tricks to help doctors who are interested in accepting self-pay patients.

The Problem of Statistics

The statistics surrounding self-pay patients are a large part of why so many doctors choose not to accept these patients in their practice. Approximately 81 percent of the revenue collected from self-pay patients is never actually recovered.

Of those who wish to self-pay, more than 30 percent default on their bills. It doesn’t increase professional confidence and leads many to refuse to accept patients who prefer to pay for their medical care out of their own pockets.

What can physicians do to make it easier to accept self-care patients in their practice?

Establish a Formal Payment Policy

It’s easy for a practice to say that they’ll accept self-pay patients, but very few of them actually have an established formal payment policy. Four things have to be considered when developing a payment policy:

  1. Insurance co-pays: The patient is responsible for paying their co-pays out of their own pocket anyway, so the office will likely already be set up to accept cash and credit card payments.
  2. Referrals: Referrals can also be problematic, as patients will seek out referrals to specialists, and these appointments may not be covered by insurance. They’re required by many insurance companies to enable patients to visit a specialist though, so it will be a big part of the business of a primary care provider.
  3. Payment responsibility: There’s also the problem of the patient’s responsibility to pay — and ensuring that the patients have the means to pay. Offices can make it easier for patients to pay their balances by offering online bill pay options. Surveys have shown that more than 70 percent of patients are more interested in paying their bills online than they are making a trip to the office to complete the same payment.
  4. Past balances: Collecting past balances is a crucial part of making sure the business gets paid for services rendered.

Each office will need to figure out the best way to handle each of these four problems, and the best way to do that is to create a formal payment policy that’s available to customers. It should be posted on the office’s website and available in print, either on request or as brochures that can be kept in the office.

Look for Hidden Health Coverage

Self-pay patients might not believe that they have any health care coverage, but it’s entirely possible that they have some that’s hidden beneath layers of paperwork and red tape. Many patients who start out as self-pay also don’t always remain that way, either because something changes in their life and they’re able to afford insurance coverage, or because they become eligible for their state’s Medicaid program.

One way to ensure that a patient isn’t paying too much for their health care and that the office is getting paid for services rendered is to set up a comprehensive insurance and healthcare checklist that’s completed before the patient arrives for their appointment.

Offer Flexible Payment Options

Let’s face it: Healthcare is expensive, which is why most patients spend hundreds or thousands of dollars every year on insurance premiums. Self-pay patients, or patients who have insurance policies with high deductibles, are more likely to seek medical care when they need it if their doctor’s office offers a flexible payment plan. Not everyone has $200-300 for the cost of an office visit, so letting them break it up over a few pay periods can help ease the burden a little bit.

Not everyone can qualify for things like Care Credit health care credit cards, so offering flexible payment options will make medicine more accessible for the average self-pay patient.

Remember That Payment Is Due When Services Are Rendered

One way to avoid big problems with bill collection is to include one caveat in the payment policy stating that payment is due when services are rendered. Many offices prefer to collect their payment at the beginning of the appointment rather than at the end, but this plan doesn’t always work for specialists that order or perform additional testing that’s added to the cost of the office visit.

For those who can’t afford to pay the entire cost of their visit on the day of the appointment, promissory notes and a down payment on the day of the visit can help ensure that the full bill is paid. Be flexible though.

If something comes up — which it often does, especially for patients who are living paycheck to paycheck — offering flexibility in payment plans can help the patients pay their bills without having to choose between doing so and buying food.

Self-pay patients have a bad reputation, but even these uninsured individuals need health care.

Establishing a payment policy, offering flexibility and checking for hidden insurance can help offices handle self-pay patients without running into too many problems.