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    Patient needs should supersede insurance demands

    Essential patient care too often dictated by what insurance covers


    Dealing with payments

    ODs know that patients are heavily influenced by what is and is not covered. After recommendations are made, help the patient understand who will be paying.

    Most ODs are experts at that part, too.

    Patients who needed new eyewear may see that the purchase is not covered until a future date. They already know they need new frames but have a decision to make. Factors patients need to consider may include:

    • How big of a change in prescription

    • Consequences of waiting

    • Time until benefits renew

    • Money needed to pay now

    It is important to remember that you may not know the patient’s specific concerns. You may assume you know, but every patient is different.

    Related: Why you need a practice mission

    What about expensive medical testing that is needed to confirm a potential sight-threating diagnosis?

    Ordering multiple tests on the same day may result in a battery of tests applied to the patient’s deductible—leaving the patient financially responsible. Regardless, the patient knows he needs the test, and you still need the test results.

    As ODs, we are perceived as the experts. We can give genuine, honest feedback to help our patients make their own financial decisions.

    Patient questions may include:

    • “Is there any harm in waiting a few months on this test?”

    • “How often will we need to do this moving forward?”

    • “When does the deductible start over?”

    • “How much do the tests cost?”

    Nobody knows what is going to happen with health care in the next few years, but everybody knows that changes to the healthcare landscape are coming with more regulation and payment restrictions.

    As healthcare costs are being shifted to the consumer, ODs need to get comfortable talking to their patients about financial obligations.

    Talking about money is never easy, but it is a lot easier when you can honestly say, “I always think about what’s best for you first. Then we can work together to worry about who’s going to pay for it.”

    Read more from Dr. Rothschild here

    Michael Rothschild, OD
    Dr. Rothschild is the Director of Practice Management at Revolution EHR.


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