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How Much Is That?
How much is that frame in the window?
The one with the tag that says SALE
How much is that frame with my insurance?
I do hope that frame is for a male
The frame is on sale and it looks great on you, Major Payne. Now we won't be able to sell it to you for the sale price if you are using your vision insurance benefits. I'm not sure what the exact cost will be for you until we dissect your plan. I will just need to get the insurance information from you that we asked you to have with you for today's appointment. You forgot it? That's okay, we have a computer and a land line for forgetful patients like you to use. We also have notes from a recent insurance webinar that the staff was required to attend during our lunch hour. Maybe you will be able to make some sense out of those.
No sir, I don't know your benefits off the top of my head. Do you see them sitting up there? The last time I checked the benefits were determined between you and your insurance company. Try calling your HR department or your insurance company's toll free cuss-tomer care hotline and have them explain your benefits to you.
Have a seat right here in the insurance time out chair. Make yourself comfortable. I need to get back to my well prepared insurance patient who is waiting and happens to love the same frame in the window.
Insurance insanity? Is it becoming reality?
Working with patients that have vision insurance requires ECPs to practice extra patience. Just when you thought it was safe to say that you understand a certain plan; the plan changes. We applaud those patients that have done their homework and show up prepared with every piece of valuable information. It's difficult at times to get a straight answer or the same answer twice from insurance companies regarding benefits.
I spoke to an ECP colleague today that spent 55 minutes on the phone with three different entities attempting to get an authorization number for a patient. None of their other state and federal funded insurance patients have been authorized for such vision care. The patient said that “someone” from her insurance company told her that there would be no problem getting the services authorized. What may seem like no problem to “someone” sure doesn't seem that way to everyone.
At the beginning of each year certain plans will require patients to meet a deductible. The patient honor system is often used by practices and any discrepancy is cleared up after the EOB is received. How much do they really owe? Do you collect what you believe to be the patient's full balance upfront? Does your patient's total out of pocket charge match that of the insurance company's? Do you charge sales tax on the overage amount, retail amount or not at all? Some practices use countertop signs at check-in regarding insurance and the patient's financial responsibility. These small signs may go unnoticed especially if they are hidden behind any POP. Do you really want to get your patient's attention? Think big and paint one of the reception area walls with black chalkboard paint so you can write and erase all sorts of appropriate messages to patients. Facebook is not the only place that has a wall for posting messages for our patients to read.
How about those patients that change their mind? You already took the time to get an authorization number and help them with their best vision solution. That really bites. What can you do? Take a deep breath and excuse yourself to stop your tongue from bleeding. It makes no sense for them to check around town and price shop. What could possibly have gone wrong? Hopefully you didn't use the ala carte insurance haggling over prices concept. I find that patients are much more receptive to one total amount due versus spoon feeding them little bites at the time like $10+$25+$150+$75+$65+$32+$18. Do your best to keep the financial transaction from turning into a mind boggling math game. Keeping your focus on the best vision solution for the patient helps them align their benefits with their wallet.
What do you do about the patients that disagree with you regarding their vision plan and are rather rude about it? You know you are correct and they keep on running their mouth. If you live by the motto that the patient is always right then work on killing them with kindness while asking them for proof. It sure would be nice to be able to do an insurance polygraph test on those types of patients.
To err is human and vision insurance can be a great reminder of that. As ECP humans we are bound to make mistakes on our end. No need to rub your co-worker's nose in it just work together to figure out how to correct it. If you find out something new about a specific plan then share it with the rest of the staff ASAP.
Take it a step further and get a group of local ECPs together for a meet and greet to share vision insurance knowledge, hints and tips. You may not be an insurance guru but you probably will know something that no one else does. Maybe your group will end up creating one insurance manual that references many different vision plans.
Hopefully one day in the future when a vision insurance patient asks you “How much is that?” the answer will be simple. You swipe their card or enter their social security number on your vision insurance genius machine and their benefits instantly print out. There's a cost to pay if your practice accepts vision insurance. How much is that (?) is the real question ECPs would love to have the correct answer to...
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