Back to Blog

New Ledger Strategies

Image of Jessica Shaw and Melissa Bergquist
Jessica Shaw and Melissa Bergquist

Ever ask yourself, “What should I do if a patient hasn’t met their deductible yet?” Believe it or not - this is a commonly asked question among a lot of healthcare providers. While each business has its own set of procedures, here is a list of some of the most common ones:

  • Creating a payment plan
  • Collecting a deductible upfront
  • Making arrangements for patients to pay a higher amount than their copay
  • Collecting the normal copay and waiting for the Explanation of Benefits (EOB)

Let's go over what a deductible is, how to handle when a patient hasn't met it and which process is the best approach to managing patient payments.

What Is A Deductible?

A deductible is the amount of money that a client must pay out of pocket for eligible medical services before their insurance begins issuing coverage for care. Following the payment of their deductible, patients usually only have to pay a copayment and then the remainder is covered by insurance.

Two Common Methods Used

  1. Patient Agreement Form (can change required payment and visit count)

This is not the best option because it assumes that you are the only one consuming the deductible and that you have acquired all the accurate patient information. Unfortunately, the EOB and the insurance response system have the final word on whether patients have met their deductible or not.

  1. Higher Or Lower Copay Payment Options

For example, you can charge $75 per visit, but once the deductible is met, then you can revert payments back to the original copay amount. If your ledger is not set to a certain number of visits, it will automatically adjust when it detects that you've received a non-zero payment. However, this approach does work well with remit payment posting since you have the option to set automatic notifications of what amounts a patient owes - whether it be higher or lower than their original copay. These changes would then be translated over to the check-in for their next visit, reflecting the new copay expectation.

Exploring New Methods

Here at Raintree, we're strongly rooted in the healthcare billing industry - so we pride ourselves on innovating new revenue cycle management tools that make it efficient for your practice and easy for your patients to pay you faster! Our simplified ledger features comprehensive reporting and engagement capabilities that help reduce staff overhead and stimulate profitability, so instead of insurance forms or higher copay payments, we let you estimate patient portions on each visit.

It’s an estimate until the claim is adjudicated (you know exactly what to bill the patient). The ledger process then becomes simple: you bill insurance, insurance responds, you assign the remaining balance to the patient, adjust what's needed and you're done.

What you typically see is - the actual EOB is received after a copay transfer at the time of a patient visit, so that you can then reverse and apply the correct charges. This causes a lot of extra clutter, but we can help you eliminate all of that by preventing numerous or repetitive copay transfers - which will also allow you to track missed payments even if the ticket has not yet been posted.

Posting Patient Payments

During the payment posting process, the copay is deducted from the running balance, so that patients aren't concerned or confused as to how their payments have been applied to their account. However, if you don't post them to the running balance, a payment can become orphaned and you may not be able to apply it to recent charges. This is a critical example of why it's important to move away from posting dates. 

For the most part, you'll want to post patient payments to the oldest balance, open-ended, so that when the patient is paying towards their balance and not their copay, they aren't confused by posting dates.

Patient Payment Engagement 

“83% of Healthcare consumers prefer electronic statements”

In terms of personifying your patient revenue cycle, our electronic statements (or e-statements) allow for patients to conveniently access their accounts via any mobile device, enroll in a personalized payment plan as well as view charges, balances and more. While this level of easy access boosts patient satisfaction and enhances payment experiences, it's our interactive communication tools that allow you to send links to patients, walk them through their account view and answer their questions in real time! Click here to explore more features of Connect

Additionally, your ledger should adjust as needed for viewing - no matter what device you may be using. Our new responsive design layout aligns your screen's fields and options in a way that’s easier to navigate and is customizable to the size of your current window. If you want to learn more about our automated RCM, Billing and Collection tools, please visit our website or contact us for more information.


Related Posts

Client Testimonial: Mohawk Medical Group

Image of Kristin Davis
Kristin Davis

Located in Bakersfield, California, Mohawk Medical Group is a small but mighty medical practice...

Read more

Client Testimonial: Deborah A. King Physical Therapy

Image of Jessica Shaw
Jessica Shaw

Founded in 1978, Deborah A. King Therapy is located in the heart of metro city Kansas and...

Read more