Creating Profitable Care Plans with Compliant Fees & Discounts

1. Creating Profitable Care Plans with Compliant Fees & Discounts Presented by Holly JensenChief Operations Officer www.CashPractice.com (877) 343-8950

2. Foolproof Financial Report of Findings Friday, February 22 8:30-9:30 am Strengthening Cash Collections in a High Deductible World Saturday, February 23 8:00-9:00 am Creating Profitable Care Plans with Compliant Fees & Discounts Thursday, February 213:00-4:00 pm Holly Jensen Dr. Margie Smith Dr. Miles Bodzin

9. www.TheCallingMovie.com

10. Antitrust Statement Please be advised that any discussion which leads to an agreement as to price among competitors is a “per se” violation of the Sherman Act. Providers gathered in any setting must always exercise caution to avoid discussions or exchanges of information with their competitors on prices or pricing at meetings since such discussions or information exchanges may give rise to inferences of agreement. Any agreement not to compete among business firms is also a “per se” violation of the antitrust laws. Thus, no discussion of division of territories or customers, or limitation on nature of business, should be held at any function. Joint refusals to deal (boycotts), including discussions of blacklists, are likewise unlawful “per se”, and no discussions related to these practices are permitted. Discussion of fees or examples used are for instructional purposes only should not be considered as a recommendation for any provider or group of providers.

11. Actual Fees

12. Develop a Rock Solid Compliant Discounting Policy The only time you offer a discount is when it is: • Required by mandate • Documented hardship • Contractual agreement • Compliant prompt pay

13. Rock Solid Discounting Policy (Required by Mandate) • If the patient is covered by a State or Federal program with a mandated fee discount schedule. (Medicare, Medicaid, etc)

14. Rock Solid Discounting Policy (Hardship) • Patients who meet state and or federal poverty guidelines or other special circumstances outlined in your “Hardship Policy” may be offered a discount for a period of time as determined by the clinic. Verification will be required.

15. Rock Solid Discounting Policy (Contractual Agreement) • If you are a participating provider in the patients health insurance plan. • If you are a member of a Discount Medical Plan Organization (DMPO) the patient will be entitled to network discounts similar to your insured patients.

16. Rock Solid Discounting Policy (Prompt Pay Discount) In 2009 , the O.I.G. issued an opinion that discounts of 5% to 15% were “reasonable” for prompt pay discounts. Anything over 15% is risky!

17. Discount Medical Plan Organization (Contractual Agreement) Use a DMPO if you need to give more than a 15% discount off of non-covered services.

18. Making Your Life Easy Set up the discount schedules within your EHR software for best practice.

19. Making Your Life Easy Make sure that the patients are attached to the appropriate discount schedule to keep your ledgers clean.

20. Making Your Life Easy Pay close attention to any updates to the discount schedule from the insurance carrier.

21. Rules of Thumb Everyone is charged your actual fee.

22. Rules of Thumb Apply the appropriate discount schedule.

23. Rules of Thumb A 5% - 15% Prompt Pay discount can be applied to non-covered services.

24. Rules of Thumb Discounts larger than 15% can be applied to non-covered services when using a DMPO.

25. Rules of Thumb Charge correctly, bill correctly, collect according to your office policy.

26. Care Plans

27. Care Plans Care plans are a reflection of the patient’s treatment plan.

28. Care Plans Care plans cover all of the care the patient will need during the treatment period.

29. Care Plans Care plans include insured and uninsured visits.

30. Care Plans Care plans are presented after the patient accepts the treatment plan.

31. Care Plans Care plans can be presented to the patient by DC or CA

32. Care Plans Care plans are must be compliant and outline the patient's financial responsibility to your office. (How do you do that?)

33. What makes a care plan compliant? • Has all services and fees clearly itemized. • Applies compliant discounts to non-covered services only. • Has a compliant Terms of Agreement, including how refunds are handled.

35. Benefits of Care Plans • Streamlines the flow at the front desk. • No confusion over patient finances. • More time to focus on patient care & education. • Better treatment plan compliance. • Increased cash collections. • Increased patient retention. • Happier team & practice members!

36. Four Business Models For Collecting Fees Pay-Per-Visit • Tx Plan: Visit to Visit • PVA: <12 • Auto-Payments Block of Visits • Tx Plan: Exam to Exam • PVA: 24 - 36 • Auto-Renewal Pre-Pay Plans • Tx Plan: Long-Term Care • PVA: 50 - 75 • Offer as an Option (not only choice) Monthly Auto-Debit • Tx Plan: Long-Term Care • PVA: 150+ • Offer as an Option

37. Monthly Auto-Debits • Results in Increased Care Plan Compliance • Results in Highest Transition to Wellness Care

40. Care Plan Prep • Knowledge of compliant discounts • Doctor’s treatment plan for the patient • If you accept insurance, estimate the benefits to incorporate into the plan

41. Incorporating Insurance Into The Care Plans • Call and verify benefits • Deductible (amt remaining) • Copays, #visit max, • Coinsurance • Benefits begin when?

43. For illustration purposes only. This is NOT a recommendation for your fees.

44. For illustration purposes only. This is NOT a recommendation for your fees.

46. Offer Payment Options • Monthly Recurring Payment • Down Payment + Monthly Payments • Prepayment For illustration purposes only. This is NOT a recommendation for your fees.

47. Types of Plans To Create • Wellness Care Plans • Corrective Care Plans • Plans with Insurance • Family Plans

50. Free eBook & Class Slides Text: “Care Plans” to (619)609-0521 With your full name and email