How to Develop a New Financial Policy for Your Practice

Written by on April 3, 2012 in Practice tips - No comments
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By Mary Pat Whaley, FACMPE

When it comes to financial policies, I recommend staying away from financial policies that are long and wordy. Try using a simple format that your patients and staff can understand and use.

The format I recommend is one with three columns titled:

  • The patient’s plan
  • What the patient does
  • What your practice does

Here’s an example of how the three columns would read:

  • The patient’s plan: Medicare
  • What the patient does: Pay your deductible ($155 for 2010) and co-insurance (20 percent of the allowable).
  • What your practice does: We will file Medicare for you.

You can use the front of the financial policy to list all the variations of plans that the practice accepts. For instance, your list of variations for Medicare might include:

  • Medicare
  • Medicare/Medicaid
  • Medicare/supplemental policy
  • Medicare Advantage Plan (HMO/PPO)
  • Medicare Advantage Plan (PFFS)
  • Medicare secondary (MSP)
  • Railroad Medicare

Lump together any like plans that you will treat the same. Then decide what you will expect from the patient at time of service or after, and what the practice commits to doing. Don’t forget to address patients being seen out-of-network and self-pay patients.

I use the back of the policy to cover everything that you would like the patient to sign off on. This could include:

  • Receipt of notice of privacy policies
  • Receipt of advance directives/living will info
  • Agreement to financial policy
  • Assignment of benefits to practice
  • Guarantee of payment

When you put a new policy in place, you have a number of options to inform your patients. Here are some suggestions:

  • Put the policy on your website.
  • Send a copy of the policy to all new patients.
  • Discuss the policy when you call patients to remind them of their appointment.
  • Discuss the new policy at check-in and/or check-out and let patients know it will be in effect at their next visit.
  • Circle the patient’s plan on the front, have the patient sign the financial policy on the back and give them a copy to take with them.

How you decide to educate the patients will depend on how much time you have between making the appointment and seeing the patient and the type of practice you have – primary care versus sub-specialty. Also, don’t forget to educate your staff. If they have not had to discuss the practice’s finances before, they will need some coaching and some practice.

If you’d like a free copy of my sample financial policy, shoot me an email at marypatwhaley@gmail.com

Mary Pat Whaley, FACMPE
is board certified in health care management and a Fellow in the American College of Medical Practice Executives. She has worked in health care and health care management for 25 years. She can be contacted at marypatwhaley@gmail.com.

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