June 15, 2009
Money Matters
All about Co-pays and Deductibles
by Joan Carr, Dir. of Revenue Management
Pharmacy patients now have a convenient way to pay their co-pays that doesn't involve stamps, trips into town or extra taxicab expense. Patients can now pay their co-pays as they pick up their medications.
As of October 1, 2009, this will become a permanent process. In some cases, people have to pay cab fare into town and back that is more than their co-pays. By paying when you pick up your medications, this eliminates that extra trip for you.
Once this process has finalized, YKHC looks to offer the same option for patients receiving out-patient medical services. Insurance cards for commercial insurance plans usually have co-pay information printed on them. This makes it easier for the patient as well as the cashier to take your payment.
Take a moment to look at your card and if you don't have that information readily available, contact your insurance company and make a list. Usually the co-pays are different for pharmacy, dental, and medical (emergency, primary care, specialists). Make sure you have a complete list from your insurance company as YKHC wants to collect the correct amount-no more, no less.
If you have a secondary insurance, get your information from that insurance plan as well. Sometimes the secondary insurance will pick up the co-pays for the primary insurance on certain things.
When you come in to pick up your medications, if you have a little extra time, go to the registration desk with all of your insurance information and make sure they have put it all into the computer system. You can ask for a print-out of the screen for your records.
Please also promptly report any changes in this information back to registration so YKHC has your updated information. As always, it is much better to take care of this kind of thing before an emergency happens.
For yearly deductibles, the process could be the same but might be different. For example, if you have an insurance plan that pays all laboratory charges at 100 percent, a deductible would not apply to your laboratory services.
Contact your plan for specifics on how this works for your coverage. Another thing to remember at the first of the new coverage year is that when you know you have a deductible, it is important to pay all or a portion if it at that first visit in the new year.
The reason for this is that when your claim is submitted to your insurance company, the biller must show the paid amount on the claim and your insurance company must keep a running total to ensure that you are not asked to overpay.
For example: On January 2 you have an office visit for $175. You know your deductible is $200, but since the office visit is only $175, that is what you pay at the visit. When we submit your claim, we show that you paid that portion of your deductible and the insurance company has it in their records. On January 16, you go to a different doctor and the visit is $150. When this doctor's office clerk verifies your eligibility with your insurance company, they will be told that you have already paid $175 of your deductible and that your payment for this visit would only be $25 (bringing the deductible total to $200).
This doctor's office also must show your deductible payment on $25 on their claim. To avoid constant discussions about your payment of the deductible, it is to your advantage to pay it early in the year.
Paying early helps YKHC keep the cost of providing healthcare services down. Postage and billing are big expenses. Help us help you in this by paying your co-pays and deductibles on time.
