Ask Caryl: Patient Financial Responsibility Script

Q: In your Becker's ASC Review column "Improving ASC upfront collections: 8 steps in effective patient financial counseling," you outline key points to discuss with patients concerning their financial responsibility. Do you have a script my ASC can use to help ensure we effectively cover these areas?

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Caryl Serbin: Financial counseling is critical to collecting upfront patient responsibility. The following is a sample dialog you can share with your patient financial counselor that will address those key points you and others:

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“Good morning/good afternoon. My name is Mary and I'm calling from the ABC Surgery Center about your visit with us on May 12 with Dr. Jones. First, I'd like to verify the information we have in your file. We have Cigna as your primary insurance. Do you have any other insurance that would cover this procedure? Was the injury due to a work, automobile or any other kind of accident? We have your name as the person who holds the plan through your employer, Acme Sign Company. The identification number is 456 and the group number is 789. Is that correct? (Add any other information offered by the patient concerning other possible payers. This is especially critical in cases where Medicare is a potential payer.)

We've contacted Cigna about your coverage for this procedure. Nancy from Cigna told us that the procedure scheduled is covered by your plan subject to the annual deductible and 20% of the allowed charges. At this time, you have met $100 of your $200 annual deductible. We will need to collect the estimated remaining balance of your deductible on the date of procedure. That will be $100. We take cash, checks, Visa, MasterCard, Discover and American Express for your convenience. How would you like to handle this payment?

I would like to mention that verifying the benefits of your plan with your insurance carrier is not a guarantee of payment. We will file the claim with the insurance company for you. Also, you will be responsible for 20% of the allowed charges after your insurance company reviews and pays our claim. We will bill you at that time and offer the same payment options as on the date of procedure.

You should also be aware that you will have at least two other bills from your procedure. Your physician will submit a claim to Cigna for his/her services, and the anesthesiologist/anesthetist will submit a claim for his/her services. There may be other services that your physician will order, such as an examination of any tissue removed for a pathologist. In that case, you would receive a bill for the pathologist's services as well.

Do you have any questions about your financial responsibility or how we bill for the services you will receive at ABC Surgery Center?

Wonderful. Thank you for your time and don't forget to bring your insurance card/cards and a photo ID with when you come in. Thank you and have a nice day."

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You will want to edit this to fit your ASC’s needs; just ensure to include all the salient points.

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