One of the most common challenges for any practice during the beginning of the year is collecting in network deductibles (a set amount of dollars billable to the patient). Most insurance policy deductibles reset on January 1st every year. Many of our patients come to us early in the year, with that concern in mind. Medicare policies thankfully are simple enough, one deductible of $147.00 for the first claim or claims processed during the year.
For private insurance (Aetna, BCBS, Cigna, HIP, Oxford, United Healthcare) is a little bit more complicated. Private insurance deductibles are assigned in different ways, at times we wont know the specifics until a claim is processed. Some policies work like Medicare and deductibles are assigned to the first claim, regardless of the services on it. However, other policies are a bit more intricate and will assign deductibles based on type of service billed. Yes, patients have their booklets that inform them of potential deductible allocations however, this information sometimes is not detailed enough. Even when calling insurance to verify benefits, you wont know that while your policy will not have a deductible for your visit services, it may have it for medical procedures or for imaging services in the same date.
Its important for our patient population to keep in mind, that fees assigned to their Deductibles will be billed to them directly. We advise that they put aside some funds every year (some policies/employers provide Health Savings Accounts for that purpose) to address deductibles in their policies. This way those couple of hundred that might be billed to you will be easier to pay.
If you have any questions, please contact our billing office and we’ll go over your information.More