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Doctor billing format for Customer Support

hello this is dr eric bricker and welcome to a healthcare z today we are going to be talking about payment at the time of service and so here we are in the admitting department of a hospital and when you come to the hospital typically there's a lot of pieces of paper that you sign and one of those pieces of paper is one to say that it's okay for them to treat you because they are going to be like potentially sticking you with needles and using knives on you so you guys say hey that's okay and then two to say that you the patient are ultimately responsible for payment so they'll build the insurance but at the end of the day you the patient are responsible and they make you sign a piece of paper uh and that's that's just standard practice that's for everybody to know okay so two so as far as payment goes your insurance company has something called an accumulator and that keeps track of how much you have paid against your deductible and your coinsurance now let's use a specific example let's say you're coming in here for a service that's going to be approximately four thousand dollars so they built four thousand dollars you have a fifty percent discount off of your service which takes it down to two thousand now you have a one thousand dollar deductible and then you have twenty percent co-insurance after that up to an out-of-pocket max of let's say four thousand so let's do the math on that so you owe the first thousand dollars then you owe twenty percent on the next thousand dollars so you'll owe a total of one thousand two hundred dollars if you have nothing already on the accumulator in other words you haven't met any of your deductible or coinsurance yet so the hospital actually will quote-unquote ping your accumulator and that accumulator may or may not be right and the reason it may or may not be right is because let's say you've had other services and those bills haven't necessarily been submitted from the other doctors or hospitals that you or labs that you might have seen okay so just because they ping the accumulator that doesn't mean it's right and they'll either do it by phone or they'll do it over the internet now the other problem too is is that once they ping the accumulator they then have to correctly translate that against your benefits which also does not happen correctly all the time so now don't get me wrong sometimes they do get it right but it should be assumed that it is going to be incorrect until proven otherwise and they're going to ask often times for payment up front either in the form of copay or they're going to ask for an estimation of that payment up front and it typically is the policy that if you don't pay that then you're not gonna get service and so just be prepared for that to either use a check or a credit card to have to be able to do that and it might be a significant amount of money it might be like twelve hundred dollars now what can you do if it's not an emergency would be to call patient financial services at the hospital in advance and get the estimate in advance see if that is actually correct against your accumulator by contacting your insurance company and then arrangement for payment in advance what's that called a lot of work so just assume that if you are not going to do all that leg work beforehand but there's a good chance that it will not be done correctly at the time of service you'll need to pay it anyway and then you'll need to clean it up after the fact so that's all i have for today thank you for watching a healthcare see