COLLECTING SMALL AMOUNTS of money from patients for deductible, co-pay, and self-pay fees has always bedeviled laboratories. However, new technology holds the promise of solving this long-standing problem.
BlueCross BlueShield of South Carolina (BCBC-SC) is currently offering a new “card-swipe” device to physicians in the state. The device lets insured beneficiaries see exactly how much their insurance plan will pay for medical services provided on that visit—while standing at the physician’s reception station. This allows patients to pay, at the time of service, for the balance of the bill which will not be covered by their health insurance plan.
Collecting At Time of Service
THE DARK REPORT observes that this technology would be a great solution for laboratories throughout the country. At the time blood is drawn from the patient, such a card-swipe reader would allow the laboratory, in real time, to verify patient eligibility and provide a bill that shows the laboratory charges, the amount the health plan will reimburse, and the balance owed by the patient. This amount could then be collected before the patient leaves the phlebotomy draw site.
A simple fact is driving this development. More patients are now required to pay higher deductibles and co-pays, increasingly reaching more than $1,000. Since patients do not pay physicians with the same diligence they pay their credit card bills, health insurers now recognize they need to support physician efforts to collect this money.
“Real Time” Claims
BCBS-SC is not the only health insurer introducing “real time” eligibility and claims processing services for patients and physicians. Humana Inc. is testing a similar system in several regional markets where it has high concentrations of patients. The goal is to improve the ability of physicians to collect such money from patients while they are in the office.
Laboratory administrators and pathologists should track similar initiatives by health insurers active in their local community. As the real-time eligibility and claims processing capability is deployed in physicians’ offices, laboratories should be able to adapt this system to their own needs.
As an interesting side note, BCBS-SC intends to issue these cards to all its beneficiaries. The technology exists to add much more data to these cards, whether it is the patient health record or its use as a “debit card,” allowing the patient to spend his/her HSA (Health Savings Account) balances during the course of the year.