I’m in private practice in St. Louis, MO and I’m noticing a trend that is beginning to annoy me, deductibles are getting higher and higher. This is caused by businesses trying to cut costs and lowering employee benefits, which is costing the patient and the doctors. My practice is growing and I’m getting busier and busier, but insurance companies are sending checks to my office with lower amounts, and asking the patients to pay out of pocket costs. This is delaying the time that the doctor collects their money and thus causing significant stress on small and middle sized medical businesses. For example, rent is paid each month, employees want to be paid every 2 weeks, phone and internet cost have to be made each month, medical supplies have to be continually added and paid for on a weekly basis, etc. It takes about 3-4 weeks from when a patient is seen to process a claim, but when a deductible is not met, it will take about 6-12 weeks to receive payment from a patient. Why should insurance companies receive the benefits and cost the patient and doctors the trouble? Most patients don’t understand and the doctors have to spend the time and money to explain it to the patient. The insurance company sends each patient 100+ page manuals (only if they request it) about their insurance plans, without explaining the plan to each patient. It should not be the doctors responsibility to explain to the patient why their insurance did not pay for their visit to the doctor or why it only covered part of the allowed amount. This only makes the patient mad at the doctor, when instead, they should be mad at their insurance company.
This situation is going to eventually hurt the patient. Small practices and large groups will not be able to stay in business if this continues to happen. What will have to happen is you will begin to see doctors’ offices like a McDonald’s restaurant. Patient will have to pay up front and order their evaluation and treatment first, then the doctor will be able to take care of you. “Can I take your order please?”