The coverage of preventive care is one of the biggest changes under the Affordable Care Act. The legislation requires that all preventive services classified as an A or B by the U.S. Preventive Services Task Force be covered by insurance companies at no cost to the patient. The good news is that preventive services are more accessible, contributing to the overall health of the general population. However, it does create a challenge for providers to draw the line between preventive and problem-focused services. Billing, patient payments, and insurance and Medicare reimbursements are impacted by the classification of a visit. Misunderstandings between the provider and the patient can lead to unexpected bills for the patient and uncollected or overdue accounts for providers. Drafting a Preventive Care Policy is a smart step to take to prevent this misunderstanding.
Clear and Concise
At the end of the day, patients just want to know what they will be required to pay. Have a clear and concise policy in writing. Many people are trying to understand new insurance plans and how the Affordable Care Act affects them. Have a policy that answers frequently asked questions. What preventive services are covered? When does the deductible kick in? When do I have to pay a co-payment? What's the difference between preventive and problem-focused care? What happens if there is cross-over? What if I have a pre-existing condition that requires treatment that is typically classified as preventive care? Obviously, coverage varies based on carrier, but the basics as outlined in the Affordable Care Act are clear across the board. Those basics can clearly be documented in your Preventive Care Policy to avoid billing surprises for patients.
Be a Resource
It's important for patients to view their provider as a resource for reliable information. In addition to your office policy, include links to the U.S. Preventive Services Task Force website, insurance carrier sites and the Center for Medicare and Medicaid Services website. There are an abundance of reliable sources available. Communicate your finalized policy effectively. Give out copies at check-in. Post it on your website. Write about it in your blog, newsletter, social media site or any other communication method you use.
Medical practice management is meeting many challenges this year and in the coming years. Legislative changes are completely changing every aspect of health care. Staying on top of those changes directly affects the financial stability of providers and patients. Being a reliable resource and clearly communicating will go a long way toward increasing overall patient satisfaction.