It can be challenging to treat uninsured patients cost-effectively but remember that providing care matters most. While there is no one-size-fits-all approach to caring for uninsured patients, several tips can help you more effectively aid them. Read on to learn more about providing medical coverage for uninsured patients.
Determine Whether the Patient Is Really Uninsured
You may have experienced it before—a patient believes they’re uninsured (or are uninsurable), but they aren’t. Direct them to the local office for Medicaid and have them go through the eligibility and qualification process. For whatever reason, many people who say they don’t qualify for financial assistance have not tried to get it from the government.
Should this process prove fruitful, you’ll have one less uninsured patient on your hands. You can also talk with the patient about other services they may not be aware of, like veterans’ benefits, worker’s compensation, or cancer screening programs.
Honestly Discuss the Costs of Your Services
Almost every uninsured patient who deliberates whether to access medical care does so because of the expense. When an uninsured patient does come into your primary care office, explain why insurance is such a great option for them. Compared to emergency room visits, regular trips to a primary care physician are a bargain.
Talk about the average cost of lab testing, diagnostic radiology, and hospitalization compared to what your office charges for a biannual visit. Should your patient require any of these more expensive services, you can also reassure them that it isn’t the end of the world.
You can provide discounts for low-income and uninsured patients, but just ensure that you’re following governmental guidelines based on financial need.
Make the Most of Your Mind
How often have you ordered a diagnostic test to be 100 percent certain of something that you were already 95 percent certain of? Everyone in the medical field does this, but we recommend you make the most of your cognitive services when dealing with uninsured patients. The last thing they need are charges piling up only to confirm something you knew.
This doesn’t mean you should forego labs and x-rays when they are essential, but that you should save them for critical moments and use your mind when you can.
Limit Polypharmacy
Low-income patients should not be stuck paying for unnecessary medications. These could be drugs provided by other health care providers, but they could also be over-the-counter pills, vitamins, and supplements. Talk with the patient about their care routine and see where they can cut costs (all the better if you can get them off of dubious treatments).
Prescribe generic drugs or switch patients to generic drugs from brand-name options when possible. This simple swap can save patients hundreds of dollars while providing the same level of care.
Seek Out Low-Cost Formularies
There are incredibly low-cost formularies available from several large retailers. Depending on your community, smaller pharmacies may be willing to match the prices—the trick is knowing what drugs are accessible. Connect with pharmacies in your area to learn what’s carried.
Work With Patient Assistance Programs
We’ll be honest—many drug manufacturers’ patient assistance programs may seem more time-consuming and frustrating than they’re worth. However, as tedious as they may be for you, they can save your uninsured patients a lot of money.
If your patient is interested in such a program, they’re on the hook for providing the financial data, which leaves a clerical person on your staff to fill out the rest of the forms. Some manufacturers are very generous with expensive medications, so it doesn’t hurt to try.
Avoid Unnecessary Referrals
It’s no secret that it’s nearly impossible to care for uninsured patients with diabetes without laboratory data to back you up. Unfortunately, blood glucose strips are quite expensive, and uninsured patients can rarely afford regular monitoring.
Sending your diabetic patients to a lab can feel like an exercise in futility with the cost and delay between the visit and reporting of the result. You can try purchasing A1C test kits and offering the service out of your office. You won’t believe how much you can improve efficiency, even with the addition of one more test to perform.
Shop Around for Lab Prices
Many primary care offices recommend labs based on convenience, not value. Learn the cash-pay rates for the lab tests you order most often—depending on the lab, you may be able to save up to 50 percent for cash-pay. You can still refer insured patients to the more convenient locations, but massive savings on labs can go a long way to helping your low-income patients.
Do the same for diagnostic radiology services. Different providers may offer cash-pay discounts for various services, so do a little research and help your uninsured patients save money. You can also opt for “older” procedures that have dropped in price compared to their modern, high-priced counterparts.
For example, you might choose an upper GI series instead of an endoscopy and recommend an endoscopy later if the patient’s situation doesn’t improve.
Chart Appropriately
You may feel uncomfortable offering anything less than cutting-edge care to all your patients. This is great in theory, but it may alienate your low-income patients in practice.
You can talk to your patients and explain that a more expensive procedure is your real recommendation but be sure to have a low-cost solution in your back pocket. It’s better to give your patients some care than to have them refuse everything you suggest due to costs.
When discussing these things with your patients, be sure to chart the information. Make a note when a patient declines a procedure due to medical reasons.
Consider Lien Purchasing
You should give serious thought to medical lien purchasing when working with uninsured patients. In essence, a company will purchase the medical lien from your office to give you a cash infusion. It allows you and your staff to focus on care rather than tracking down patients for their payments.
Now that you have this guide to providing medical coverage for uninsured patients, work with them to get the help they need.
