Five Tips to Help Navigate Deductible Reset Season - I-conic Solutions

Five Tips to Help Navigate Deductible Reset Season

  • The start of a new year, however, means that health insurance deductibles reset and patients become significantly more aware of their updated financial commitments.
  • For the increasing number of people with high deductible health plans (HDHP), this is particularly valid. Patients must pay the whole deductible amount before their insurance coverage begins when health insurance deductibles reset, which causes worry.
Tip #1: Develop scripts to navigate common conversations.
  • What medical services are subject to a patient’s deductible and which are not?
  • What the patient will pay when the deductible has been met?
  • What distinguishes a family deduction from an individual one?
  • How do in-network and out-of-network deductibles differ from one another?
Tip #2: Leverage technology to empower staff and improve the patient's financial experience.
  • The more focused call centre employees can be on developing patient involvement and trust, the more readily they can assist patients in understanding what they would need to pay out-of-pocket. 
  • The No Surprises Act, a federal law that went into effect on January 1, 2022, which was designed to protect consumers from the majority of surprise medical expenses, also stipulates that good faith estimates must be disclosed. 
  • The use of cost-predictive technology can be quite beneficial here. Similar to how a new calendar year brings the need to confirm eligibility.
Tip #3: Consider outsourcing.
  • Even fully staffed call center’s can find it difficult to handle the increase in call volume brought on by deductible resets. As they negotiate new policies with new perks and coverage constraints, patients frequently have questions.  
  • An additional frequent cause is an increase in claim volume after end-of-year treatments.  
  • You may better outsource fully or partially outsourcing than staffing internally.
Tip #4: Focus on information integrity.
  • Getting the appropriate data at the time of scheduling has a good knock-on impact on the financial experience of the patient and may even lower the overall call volume. 
  • Train personnel to update patient data proactively rather than after an incident.
Tip #5: Invest in training that helps staff deliver a high-quality patient experience.
  • Patients are less likely to contact back a second or third time if they feel validated and understood while having their questions addressed the first time. The total workload on the current staff will be lessened by giving first-call resolutions priority. 
  • When patients have concerns, they certainly want answers—but they also want answers that are given with compassion and understanding. 
  • In terms of improving the patient’s financial experience and perhaps lowering overall call volume, this can go a long way. 

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