The number of uninsured and underinsured Americans is on the rise. This creates a difficult situation for patients and doctors alike. Healthcare practitioners take oaths to help their patients, but what can they do if the patient has no insurance and is unable to pay, or has insurance but cannot afford deductibles and out-of-pocket costs? Read on to find out about 10 things physicians can do to help.
- Share Resources for Free Care
There are resources available for families in distress. Doctors should familiarize themselves with organizations like The LifeSavers Foundation that provide no-cost medical care and other forms of assistance to needy children and families. They can then refer indigent patients to these organizations to put them on the right path.
- Schedule Expensive Tests and Treatments Wisely
Patients who have insurance but are unable to pay deductibles may benefit from scheduling expensive tests and treatments for later in the year after their annual deductibles have already been met. Those who have no insurance may also have variable income, so it may be easier for them to pay for care during certain times of the month or year. Try to accommodate those financial needs by scheduling non-essential or less-than-urgent tests and treatments for times when patients are most likely to have access to sufficient capital.
- Use Creative Scheduling
If the office charges $200 for a full consult, but the patient can only afford half that price, consider offering a lower-coded visit instead. Try scheduling the visit for a slow period like the mid-afternoon when the office wouldn’t normally be seeing too many other patients. Just make sure the patient still gets the medical attention he or she needs during this shorter visit.
- Offer Payment Plans
Many physicians offer payment plans. If the patient can pay a portion of the doctor’s fee up-front, a payment plan will allow him or her to pay down the balance over time, or even pay it off all at once if the family’s financial situation changes. Make sure the administrative staff has a system in place for setting up payment plans, and have the patient sign an agreement that details the total cost of the visit and the amount of his or her monthly payments.
- Charge Fees on a Sliding Scale
Creating a sliding scale fee schedule allows doctors to offer financial breaks to low-income and uninsured patients without driving their clinics into bankruptcy. The idea behind sliding scale payments is to offer a discount based on the patient or family’s income. Use the Federal Poverty Level guidelines used for determining state health insurance eligibility as a starting point for coming up with a sliding scale fee schedule and make sure it offers realistic levels of relief given the area’s cost of living. If the clinic can afford it, consider offering no-cost services to the lowest-income patients.
- Let Patients Negotiate Payments
If a patient can make a partial payment, consider taking it. This shows a good-faith effort to pay for services and indicates that, if the patient’s financial situation changes in the future, he or she will be willing and able to pay the full amount for future exams, tests, and treatments. Allowing patients to negotiate lower payments lets them keep their dignity and get access to the care they need without driving them further into debt.
- Accept Some Pro Bono Patients
Most successful clinics can afford to see at least a few patients pro bono. It wouldn’t be financially sustainable to see all patients at no cost, so make sure the clinic has sufficient financial resources to take on these extremely low-income patients before agreeing to see them. Doctors can’t take care of their patients if their practices are in financial jeopardy, so clinics should limit the number of pro bono patients they will see based on what they can comfortably afford.
- Barter for Services
Many low-income patients are willing to trade goods or services for the care they need. Taking this approach can benefit both patients and clinics. For example, a doctor could offer consultation and full exam or cover the cost of diagnostic testing fees in exchange for having a waiting room repainted or a website redesigned. Some patients may also be able to offer goods such as home-grown food or hand-made products in exchange for care, although this form of bartering tends to offer a less-balanced exchange.
As with allowing families to negotiate partial payments, letting them barter for needed healthcare services helps low-income patients maintain their dignity in addition to giving them access to the care they need. Clinics that let patients barter for healthcare services should determine the value of the goods or services being offered in advance since they’ll need to declare them as income on their tax forms.
- Partner with Financing Companies
Some third-party lenders will work with healthcare clinics to provide financing for patients who are unable to pay for services upfront. Choose a financing company that is willing to work with low-income consumers, who often have poor credit or no credit. Low-interest rates can also help to ensure that patients will be able to repay their loans.
- Be Empathetic
If there’s no way to see the patient at the clinic without causing undue financial burdens for either patients or providers, doctors can still help by exercising empathy. Remember that with more patients than ever responsible for covering the cost of their care, stress levels can run high. Be patient and take all possible steps to help the patient find alternative resources if the clinic can’t help.
The Bottom Line
All Americans need and deserve access to medical care, but not everyone can afford to pay out-of-pocket expenses. Doctors need to balance the financial solvency of their clinics against their duty to provide adequate care. Make sure that offering reduced cost visits, bartering for services, or implementing a payment plan will not drive the clinic into bankruptcy, as this will cause harm to the clinic’s other patients.
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