New Year … New Deductible!

Most clients’ insurance deductibles follow the calendar year, meaning their out-of-pocket expenses start over January 1, of each year.  There are a handful of people, like state employees of Texas, whose “benefits” restart in the middle of the year.  However, for most, with the well wishes of a Happy New Year come unhappy realities of high deductibles to be met.  In most cases of serious injury or surgery, this is not an issue.  In our genre of medicine, we sometimes have to make the case for spending money on services for an ailment that some may feel can wait a little longer to be addressed.  For some people physical therapy is not a “necessity” (unless following a surgical procedure or severe loss of function). In pelvic health particularly, some patients have lived for years with their symptoms. In their minds, what difference will a few more months make?  In outpatient settings specifically, there is usually a dramatic decrease in visits in the month of January compared to the last three months of the previous year.  Here are some tips to decrease the new deductible blues…

1. Get new copies of insurance cards even if the client says “Nothing has changed.” Sometimes ID numbers change or amount owed varies slightly, and you do not want to give the wrong information at the time of the visit.
2. If you have the personnel, re-verify each patient’s benefits.  Financial ambiguity is a major cause of why patients do not come back for follow-up therapy sessions.
3. Have a payment plan/arrangement in place.  It is helpful to give the patient options for payments to make high co-insurance amounts seem more manageable.
4. If the patient has a high co-pay, teach the front office staff how to do an excellent job of explaining the benefits of being evaluated, and let the skills, knowledge, and personality of the therapist secure the follow-up visits.
5. Consider offering self-pay options at a discounted rate.
6. Once you’ve written your payment policy have each patient read, sign, and date it. Keep a copy in the chart, and if the client complains about the bill or denies being aware of financial responsibility, you can refer back to this document that displays his/her signature.
7. Educate clients on the fact that the deductible has to be met eventually, and there’s no better way to meet it than receiving skilled physical therapy services! Reassure them that it will be money well spent and deliver a bravura treatment worth paying for!

AUTHOR

NaKisha Jackson, PT, DPT currently practices in Arlington, TX in an outpatient setting solely devoted to enhancing the pelvic health of men and women. What she enjoys most about physical therapy is the way it empowers people to take an active role in their health and make lifestyle changes that improve their overall quality of life.  When she is not working, she loves traveling and spending time with her husband Matthew, family/friends, and her dog Coco.