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With Medical Debts Rising, Doctors Are More Aggressive About Payments


Then, as she heads out of the building, she passes a second payment desk, where Deanna Tharp sits, one of two employees at Mid State Orthopaedic whose sole job is to collect payments from patients, often even before they have surgery. Tharp has an incentive to do it well; the more she collects, the bigger her bonus will be.

Tharp starts with the practice’s electronic record system. “This is the rotary cuff repair code, this is the price for it, this is Dr. Leddy’s price,” she explains to Jackson-Price.

The system can access a patient’s insurance details to find out exactly how much she’ll owe. The total for the orthopedist’s portion of Jackson-Price’s surgery comes to $1,917.90. Once the insurance company’s portion is deducted, Jackson-Price will owe the doctor a total of $831.

Jackson-Pryce says she’ll be able to pay the total amount up-front, although the practice recommended she wait a few days so they could double check her deductible. For those who can’t pay up-front, Tharp can help them set up a payment plan.

Patients who still can’t make it work are advised to seek treatment instead at the local safety-net hospital. Hospitals usually offer some sort of charity program to help low-income patients pay for care but that’s not the case for most private physicians practices.

The doctors at Mid State do offer some free care when they can, says practice administrator Michael, “but at the end of the day, this is still a business, and still we do have to keep the lights on.”

Soon, patients will be offered an even faster payment option. They’ll be handed a tablet computer in the waiting room with a credit card swiper attached, and given the option to store their payment info for future bills. The upfront payment model is working; bad debt at Mid State Orthopaedic has gone down by 25 percent over the past two years.

But when patients hand over that kind of cash, Michael says they expect to get what they paid for. Like the fancy new building, which, he acknowledges, drives up the cost of care.  “But that’s the expectation of patients these days. And if we can’t make that happen, they’re going to go where they can get that,” he says.

Jackson-Price says it’s the quality of the doctors she cares about, not the amenities.

“I’m old, don’t you know that? Old people don’t get concerned about buildings. We figure we’re paying for it. Oh boy I gotta pay more ‘cause the building is nice!” she says with a laugh.

After nine surgeries over the course of her life, she says she’s used to paying a portion of her medical bills. So she always sets $1,000 aside in case something happens. But, she says, that kind of money can cramp your style.

Tue, Apr 15 2014

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