October is just around the corner. Cool fall breezes, football games and hot cocoa are on their way, along with Open Enrollment time for many plans (especially government plans such as Medicare).
Why is Open Enrollment important? For patients, it provides an opportunity to exercise any changes they would like to make in their coverage. There may be a more affordable plan, or one with better benefits which more appropriately suits the patients’ needs, as well as adding or dropping plans offered through employers.
For a provider, open enrollment is important as an opportunity to interact with patients. Many providers find themselves in the situation of educating members. It’s uncomfortable for some providers, but it’s a great way to educate members about proper utilization, access of care, and understanding general benefits. The members value the relationship with their healthcare professionals and they trust what you think. This puts you in a powerful (and sometimes dangerous) position to offer advice about health plans.
It’s easy to say “our office doesn’t like Healthcare Plan X, so don’t choose that one.” Avoid those types of positions, and rather take a few minutes to engage the patients about their personal needs. From the patient’s perspective, you should be in every plan that comes along, and helping them understand those business decisions on your part can help them make better decisions on theirs by considering more than just the network.
Educate your front desk to know the difference between the types of healthcare plans, and how to properly collect copayments or information from patients while they’re standing at the desk at check-in or check-out. This extra step will save you a lot of frustration later on. Utilize any tools your EMR may provide to help you verify benefits prior to service, so you can ensure the patient has coverage with the plan for which the card was provided.
Consider engaging with plans performing open enrollment and invite them into your space to engage with and educate patients with you. You can also ask them for information about their plans which you could hand out as educational tools to members. Each of these interactions opens the conversation with your patients about their care, and how you can participate in improving their health.
If you are using a billing service, that service may have additional tools or services they can offer to help as well. Open Enrollment for many members means they will change plans in January. Being prepared for those changes by checking benefits regularly (we recommend a minimum of every 60 days) helps your practice stay on top of those changes and minimize issues with carrier payments.
Questions? Reach out to Team CPR at (501) 223-2776 for information on how we can help.