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How to Discuss Care Costs with Patients.

How to Discuss Care Costs with Patients

There is a lack of communication between doctors and their patients, in payment matters.

Patients are not usually aware of their responsibility until after a visit, which is unlike many other payment experiences where there is a clear price tag and an understanding of how to pay.

But medical practices can remove the uncertainty in healthcare payments by communicating early with patients, setting expectations, and offering payment convenience.

This includes talking about payment responsibility, insurance coverage and cost estimates, offering multiple payment options including online payments and automated payment plans, and enhancing patient convenience through electronic statements, email notifications and text notifications.

The cost conversation

Medical costs can be centered around questions like “Will insurance cover this?” or “How can we get insurance to cover this?”

As nightmarish as those conversations were thought to be, such questions do seem rather quaint and simplistic by today’s standards, citing discussions today of questions like, “What does covered even mean?” “Can I afford this test or procedure even if it is covered?” and “Would I be better off not even using my insurance and just paying for the medical test or procedure myself?”

The reason is that people are shy about discussing cost of care.

For folks that live paycheck to paycheck, the discussion involves how to save up to afford a more expensive but necessary evaluation or treatment or procedure.

Without these discussions, many patients would oftentimes not get any medical care or allow the problem to fester until it becomes a more expensive emergency.

Also, for about half the medications prescribed, patients will ask whether it is covered by insurance.

They asked routinely whether all the medications they take are absolutely necessary.

Patients are often most concerned about costs of specialty medications like insulin, or anticancer drugs. Doctors often try to use generic medications first.

Some patients prefer to pay directly rather than going through insurance because deductibles are so high.

The same is true with medications. Before prescribing, doctors must discuss with his patients if they can afford them.

Such discussions are important, because patients sometimes are embarrassed to say they cannot pay for meds and won’t get them filled.

Your job as a doctor is not only to help them recover from or control an illness but also to look at their overall health and at times that means financial needs as well.

All physicians should have these discussions with patients, because they may not be compliant and their blood pressure is still high because they could not pay for that third medication.

Navigating the discussion

Some doctors routinely have their medical assistant screen for financial or social economic barriers to care.

Some patients are not interested in telling these issues unless it is really bothering them.

In the contrary, with a medical assistant staff it is easily to connect better, and they are able to elicit this information.

They do this simply by asking if the patient has any questions or concerns.

Physicians need to be open and honest, and not just say what the patient wants to hear.

Most people still don’t even understand what coinsurance, deductibles or networks are, and the conversations are still not as prevalent as i would like them to be, but definitely more common.

If you’re honest with them about their options, it can drive the relationship even further.

Recommending resources

One of the most common questions patients ask physicians is where they can find help in reducing their out-of-pocket costs

Prescription drugs often are a good place to start.


Medical Manage

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