Having financial counselors on staff is becoming a new reality for oncology practices as patients are responsible for out-of-pocket costs and more are participating in health insurance exchanges, says an article in Healthcare Finance News
. Practices had been able to use front-end billing and collections staff in the past.
Luckily this doesn’t necessarily mean adding new staff. People already dealing with billing and collections can be trained – internally or externally – to take this responsibility.
David Zetter of Zetter Healthcare Management Consultants and member of the National Society of Certified Healthcare Business Consultants said the time it takes to properly train staff can vary widely. Recent training he has provided took two months in one practice; in another, it is taking well beyond six months.
The role of financial planners on staff focuses on two aspects—financial policy and benefit eligibility, according to the article. Financial counselors help create the financial policies for the practice and also ensure that patients understand what’s expected of them—usually through an initial patient meeting. Zetter said that patients need to know their part of the payment and the cost of any fees that would be applied if the practice has to begin a collection process.
Financial counselors may also find themselves verifying patient benefit eligibility. Counselors should be familiar with the benefit coverage from a financial standpoint, and communicate that information to the patient.
Financial counselors can also work with patients on creating a payment plan. The plan can cover discounts for paying upfront, or how patients can pay over time, or offer post-dated checks. Zetter recommends keeping credit or debit card information on file if possible to pay for outstanding balances. The financial counselor would be responsible for taking care of that process and ensuring it is compliant with industry and HIPAA regulations.
The most important payment option a financial counselor will deal with is making sure patients are paying upfront for services. If a provider can’t verify eligibility, then they need to have a patient pay upfront. The financial counselor can talk with patients about refunding money after an insurance company pays its share.