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Health Care Reform:

Health Insurance & Affordable Care Act

With Medical Debts Rising, Doctors Are More Aggressive About Payments


Another option is to collect the payments before a procedure even happens – an approach that’s proved particularly effective at Mid State Orthopaedic.

On a recent morning, patient Gayle Jackson-Pryce, 63, stopped by the practice to have her shoulder checked.

“I was on a business trip and I picked up my luggage and immediately thought, ‘Ooh, did I tear something?” she recalls.

Dr. Michael Leddy tells her she needs surgery on her shoulder. As she leaves the exam room, she passes by the billing desk, where she pays her $50 copay for the office visit.

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.”

Tue, Apr 15 2014

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