How you handle Medicare deductibles affects your bottom line

Why this is important

The way that you process claims that have a Medicare deductible is important.  If done right, it will improve overall collections.  A good billing company or department should know this simple trick if they want to make sure to maximize collections.

This technique will help you collect more and if you are neglecting to do this, you are definitely collecting less for your stakeholders.  It is one of those little things that when coupled with other processes combine to increase overall collections significantly–and it is easy to implement.

What problem are you solving with this process?

The patient-paid deductibles are not getting substantially paid. No matter how many invoices, statements, calls to a patient (or even sending the accounts to collections), the collection rate is low versus collecting that deductible from Medicare. Compounding this, these same deductibles are not paid by Medicaid programs in most states.  Medicaid is often the secondary payer to Medicare, leaving these deductibles uncollectable.  The deductible simply becomes lost revenue.   

But a simple change in billing process can assist in making sure the Medicare deductibles on Self Pay and Medicaid secondary claims do not show up on your billed transport.  

Simple solution – keep unpaid Medicare deductibles off of your bills  

How is this done?  First identify if the Medicare patient for this claim still has an unused deductible.   Next hold off on sending Medicare claims with unused deductibles until other payers’ claims for a Medicare payment have exhausted the deductible. This one technique will add significant revenue to your annual collections.  We also take advantage of this technique to ensure you get paid from programs like California’s QMB and other states’ programs, where Medicaid will not pay that deductible and you cannot bill the patient. We ensure you are not losing that revenue by waiting until another payer sends a bill exhausting the deductible.  By waiting, you will collect more. 

The next part of this technique will ensure minimum cash flow reduction. The second critical piece of this important technique is to recheck often to see if the deductible has been used.  At minimum, you should check two or more times a week. This provides for immediate billing once the deductible is exhausted.  

This is one in a series of simple changes to the billing process that can enhance your overall collections.  Look for future blog posts with other valuable techniques.