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Dealing with Unmet Deductibles

Unmet deductibles challenge health care practices and interrupt cash flow.  Long gone are the days when collecting patient payables meant collecting $10 copays.  More and more patients have chosen a high deductible health plan to save on premiums and/or take advantage of health savings accounts (HSA).

Unmet Deductible This means that each patient must pay out of pocket for health care services until their deductible is met.  After that, their insurance will pay your claims.  The amount of the deductible varies from policy to policy.  However, the most common amounts range from $200 to $6,000.

Unfortunately, each new year finds patients, providers and clinic staff struggling to meet these deductibles.  Each must find an effective way to deal with the impact when deductibles reset.  Here are a few basics for improving your patient collections.

Tips to Improve Collecting Patient Deductibles

  1. Prior to the patient’s appointment verify eligibility and know what your patient will owe.  This is especially important because patients change insurances which results in changes to the deductibles.
  2. Always verify whether or not a deductible has been been met when you call to verify the patient’s insurance.
  3. Reduce front desk awkwardness and instead tell the patient why they will owe before the appointment.  Letting the patient know what they will owe is critical.  You can even do this when you place appointment reminder calls.  Patients don’t like surprises and they are being educated to understand that they will owe more than a $10 copay.
  4. Make it easy for them to pay and give them options.  Let them pay on a credit card, by cash, check, money order and even PayPal.  Make sure your staff offers to accept payment during the appointment reminder call or when they check-in or check-out.  Also, make sure that you have this payment expectations/information posted in several places in the office, including the waiting area and patient rooms.
  5. Implement a credit card on file policy whereby your patients agree to have all or some of the balance charged to their credit cards each month.  You do not want the liability of keeping their credit card information onsite, so use a certified and secure third party to retain the information.
  6. Promote your patient portal and if you don’t have one – get one.  Online payments are the way to go!  Some patients just want to go online and make a payment.
  7. Collect a flat amount in advance.  If you don’t know how much the patient will owe, then collect a flat amount.  Let the patient know that after the claim has been paid the balance will be billed to them.
  8. Inform your staff of how to collect money.  Your staff should be well-informed of all office and financial policies.  Consider providing staff with scripts to help them collect patient payments.

Time of service collections and lots of communications will help to make collecting deductibles easier and in the long run reduce everyone’s stress during ‘deductible season’.

Cloud or Server – What’s right for my practice?

Cloud based Server

Every private practice health care provider has had to weigh and measure whether a cloud-based or server-based software solution is right for their practice.  As your practice grows, it is good business to assess whether your initial decision is still the right one.

A few months ago, one of our clients found themselves in the path of a raging fire.  Fortunately, they had made the decision to be cloud-based.  Initially, they had to access patient notes via a tablet and then utilized a temporary office to see patients.  They never missed a beat.  All of the patient care data was completely backed-up and accessible from anywhere they were.

Cloud-based servers can be an attractive solution for many reasons.

  1. They provide on-going and instantaneous back-up systems;
  2. The back-up sites are in multiple locations throughout the United States so redundancy is in place;
  3. The responsibility and cost to maintain the cloud-based servers are not an expense the practice must bear;
  4. You do not have to worry about upgrading or maintaining the servers; and
  5. You save money because you do not need IT staff/contractors to manage, maintain or troubleshoot the servers.

Yet, there are those who feel a server-based solution is best for them because:

  1. They maintain direct control;
  2. They feel that troubleshooting response time is faster with in-house servers and contracted IT staff; and
  3. Despite the associated costs there is a level of trust in server-based over cloud-based.

Regardless of the solution you choose or have chosen for your practice it is important that you have a technology disaster plan.  No one plans on a disaster.  Most of us have never and will never experience one.  But, if there is one will you be able to access your patients’ records, refill prescriptions and DME orders and keep your practice going?  So, whether it is an extended power outage, hurricane, fire, earthquake, tornado or a flood you need to be prepared.  Is your data backed up off-site and out of your geographic area?  Will you be able to access the patient data if you have to practice in another location?  Could you function if all you had was an iPad or tablet?

Assess your situation and make changes as you deem appropriate.  Don’t wait until it is too late.
Server based


Is Your Practice Ready for MIPS?

The Merit-based Incentive Payment System (MIPS) program is a key component of the MACRA Quality Payment Program (QPP) and is expected to be the more popular path for 2017, the first performance year.  Under MIPS, the Meanighful Use (MU) Medicare incentive program, Physician Quality Reporting System (PQRS) and the Value-Based Modifier (VBM) program will be consolidated into one program.

We’ve consolidated the key highlights for the 2017 transition year and compiled them into this concise overview.  It’s short and created for anyone in your practice wondering what to do next.


Is it too late to start?

  • You can start anytime between January 1 and October 2, 2017

Pick your pace

  • Test: submit a minimum amount of 2017 data to avoid downward payment adjustment.
  • Partial: submit 90 days of 2017 data for a neutral or positive payment adjustment.
  • Full: submit a full year of 2017 data and you may earn a positive payment adjustment
  • If you don’t submit any 2017 data you will receive a negative 4% payment adjustment.

Reporting process

  • The submission of data remains the same as in the past
  • Quality Measures via claims based reporting or registry
  • Advanced Care Information (ACI) and IA categories use the attestation process as you did with Meaningful Use

Requirements reduced

  • ACI measures reduced from 11 measures to 5 measures
  • Cost performance category (formerly VBM) – 0% weight in 2017
  • Quality cross-cutting measures and domains removed to avoid a penalty and not earn an incentive, need only report on 1 patient.


MIPS eligible clinicians billing Medicare Part B listed as Physicians, Pas, NPs, Clinical Nurse Specialists, CRNAs.

Exempt eligible clinicians

  1. Physicians in their first year of Medicare Part B participation
  2. Membership in an advanced APM
  3. Physicians with less than $30,000 in annual Medicare revenue/or have less than 100 Medicare patients

MIPS Performance Categories for 2017

Quality (formerly PQRS) = 60%

  1. Submission: Claims Based, Qualified Registry or EHR
  2. Report: 6 measures
  3. Resource:

Advanced Care Information (ACI) Formerly MU = 25%

  1. Submission: Attestation based on your health technology.  Attest to 5 required measures for a minimum of 90 days.
    1. Security Risk Analysis
    2. ePrescribing
    3. Provide Patient Access
    4. Send Summary of Care
    5. Request/Accept Summary of Care (bonus credits available)
  2. Resource

Improvement Activities – IA  (aka from proposed rule CPIA) = 15%

  1. Submission: Attestation based on your health technology.  Complete 2 – 4 improvement activities for a minimum of 90 days
  2. Resource:


Does Your Medical Practice Need a Website?

8 Website Must Haves…

website must haves

Medical practices often asked for our opinion about the value of a website for the medical practice.  We are not website professionals.  However, we have had the pleasure of working with some very talented design and development people. Thanks to their input, as well as numerous articles, the consensus is a resounding “Yes”!

Regardless of  your specialty, the reality is people are searching online for you.  They are interested in who you are, what your credentials are and about your practice.  They are trying to determine if they will feel comfortable with you.  Whether you realize it or not, people search the web and make decisions based on your website.

It is true that potential patients may still make an appointment with you if they can’t find you on social media or if you don’t have a website but why leave it to chance?  So if you are thinking about development, re-design or updating we thought you might find the following article of use, The 8 Must-Haves for Your Medical Practice Website. 

Three Ways to Increase Your Practice Collections

How much money is your practice losing?Increase Collections

Collections are the life-blood of your practice.  Yet, doctors in the United States lose roughly $125 billion per year due to poor billing practices.  According to an MGMA study, an average practice will recover just $15.77 for every $100 owed once a patient defaults on the amount they owe to you.

Below are some ways that can be implemented in order to maximize your collections. You will find that most are fairly easy and do not require additional resources.  They do require a concentrated effort but will prove to be financially beneficial.


  1. Make sure you have a patient portal.
  2. Remember, having a patient portal isn’t enough.  You must maximize your patient portal.
  3. Make sure you have an online bill payment option.


  1. Give patients a wide variety of options for paying their bills.  Be sure to accept cash, checks, credit cards and debit cards.
  2. Encourage patients to register a credit card to keep on file with your office and make sure they enroll in an automatic pay option for their patient balances.
  3. Encourage patients to pay past account balances and current charges at the time of service.
  4. Train all staff to firmly but gently communicate with patients about patient financial responsibility issues.
  5. Be willing to refuse service to patients who do not pay.


  1. When you transition to a billing company, you get trained specialists dedicated to medical billing.
  2. Outsourcing means you don’t have to worry about personnel issues, covering vacations or ongoing training expenses.
  3. Utilizing a billing company will afford you the benefits of state-of-the-art software, up-to-date processes and key reports in a timely fashion.
  4. Dedicated efforts, working every denial, and not accepting zero payments will result in your practice getting more money faster.

Maybe all three ways won’t work for your practice or maybe you’ve already done some and that is great.  Every way that you implement will only help to increase your practice collections.