By: Justin Irizarry
We’ve all heard the advertisements touting no money down, no interest, and no payments for x days – but did you know that a healthcare franchise technically offers this type of payment option? As a result of billing practices, many urgent cares offer this type of “no-no-no” advantage to patients. These payment options aren’t advertised but exist as a symptom of the practices in place. In addition to not being advertised, these billing practices don’t do what typical retail campaigns do: they don’t draw in new patients, they don’t increase return visits from existing patients, and they result in lost revenue. While this type of billing might be beneficial to retail businesses, it’s not ideal for a healthcare franchise.
One typical situation where the “no-no-no” payment plan occurs is when a patient receives services and then receives a bill after the services are rendered. Many practices operate in the following manner: a patient receives services, does not pay a co-pay, and is told they will receive a bill for the remaining charges that an insurance provider doesn’t cover. This can severely hamper the operation of a healthcare franchise as it sets patients up to not pay their bills or pay well past when services were rendered. Even if a patient has insurance that requires a 20% co-pay on the total cost of the visit, a location can tally up the charges and collect that amount on the day of services. Then if insurance comes back with another amount that they will not cover, a bill can be sent to the patient. If a healthcare franchise collects at least 20% upfront in this scenario, it softens to the blow to the bottom line.
To protect your healthcare franchise from this unintended pricing structure, there are some steps you can take.
- Make Sure Personnel is Trained. Ensuring that the front desk staff at your healthcare franchise is aware of proper billing procedures and understands how insurance works is key in making sure you don’t lose valuable revenue, or spend forever trying to collect it. Having expert staff when it comes to billing and insurance is essential.
- Have a Policy and Make Patients Agree to It. Many healthcare franchise locations have financial policies and ask patients sign documentation that they understand and agree to billing procedures. This policy should outline what the billing procedure is, when payments are expected, and outline what late fees will be incurred and when. Once patients agree and sign the document, keep it on file in case of past due accounts.
- Verify Patients’ Insurance. Your staff should know to verify a patient’s insurance information and validity during check in. In addition, understanding what’s covered in the policy is crucial to being able to charge the appropriate amount and getting paid for services rendered.
- Submit Claims and Send Bills Immediately. Making sure your patients know how much they owe while they’re still at your healthcare franchise can increase the chance that you’ll be paid in full. In addition, submitting claims and sending bills in a timely fashion is key in collecting the dues that you’re owed for service rendered.
Making it as easy as possible for your patients to settle their dues will result in increased payments. Be clear and concise in your communication about the cost of services rendered and make it simple for patients to pay. Offering online payment options at your healthcare franchise can also contribute to timely payment and staying on top of billing.
OrthoNOW is the first and only Orthopedic franchise. Contact Christine Dura at Christine@orthonowcare.comfor more information about franchise opportunities.
Justin holds a B.A. in Economics from Cornell University, where he was a 4-year varsity baseball scholar-athlete, and a M.B.A. from The Wharton School at The University of Pennsylvania, where he was a Joseph Wharton Fellow. In addition, he has earned the right to use the Chartered Financial Analyst® (CFA) designation, the most respected and recognized investment designation in the world. Justin has more than 13 years of experience acting as a trusted advisor and interim executive for a wide range of companies. His diverse business experience has led him to advise for boards of directors and senior management teams in the education, information, digital real estate, medical, and technology industries. Justin started his career on Wall Street with the Education and Information Group at Scott-Macon, Ltd. As the Vice President of Scott-Macon, he was responsible for sourcing and executing transactions in the $50 – $300 million range. Justin joined OrthoNOW® in 2010 and started the Franchise with Dr. Alejandro Badia in 2012. In addition to his role as Co-Founder &CFO, he serves as the Director of Operations of OrthoNOW® Doral.
Justin remains active with his alma mater and serves as a volunteer mentor to incoming freshman as part of the university’s Alumni-Student mentoring program and as a university interviewer for South Florida applicants to the university. Justin was recently named a Top 40 Under 40 by South Florida Business Journal for his contributions to the South Florida community as the CFO and Co-Founder of OrthoNOW®, the nation’s only network of orthopedic urgent care centers, and for his work in developing and activating a business model that changes how South Floridians access expert orthopedic care on-demand and at a cost-effective rate.