It’s a situation any provider wants to avoid: you take an appointment with a patient, provide outstanding service…and then find out they’re out-of-network. Now, you’re looking at time spent haggling with their insurance company over reimbursement, and spending time and resources chasing down full or partial payment from the patient.
Instead of focusing on getting better, your patient is stressing out about a medical bill they may not be able to pay. And, of course, they’re less likely to be able to visit you for follow-up care, or become the long-term regular patient you probably want for your practice.
Grow your practice with our weekly newsletter.
This unfortunate situation occurs in part because many patients don’t understand their insurance coverage. In fact, a Zocdoc-Kelton Global Insurance Confidence survey found that only 28% of insured Americans feel confident their doctor is in their network, and 16% have made an appointment without being sure their insurance will cover their care.
And that patient uncertainty is understandable, since health insurance provider databases often contain inaccurate information. The New York Times reported last year that insurance network databases are often severely out of date, listing practices as accepting new patients when they actually aren’t, and even including frequent mistakes about which doctors work for which practices. So even if a patient understands their coverage, they might make an appointment with a doctor outside their network due to outdated information — or have trouble finding a doctor at all.
While you can’t control what health insurance providers do, taking a few steps to update your in-network insurance list can make a difference and help you and your patients avoid out-of-network visits.
Here’s how often you should be updating your list — and where to do it
First thing’s first: make sure you’re notifying every health insurance network you’re part of as soon as there are any changes in the networks you’re part of, the types of insurance you’ll accept or whether you’re accepting new patients.
If letting insurance providers know right away isn’t possible, set up a twice-weekly “check-in” time when you or your office manager can check for any change in the insurance you accept and whether you’re accepting new patients, and notify the insurance provider accordingly. Some states, like California, require providers notify insurance companies within 5 days if you’re accepting (or no longer accepting) new patients, so twice-weekly check-ins should be sufficient to comply with the law.
You should also take advantage of your online presence to let prospects know if you’re accepting new patients or changing the insurance plans you’re able to accept. Keep this information up to date on your website, making changes immediately or during your twice-weekly check in.
Post a status update on your Facebook, Twitter or other social media to let your followers know you’re accepting new patients, or direct them to a page listing your insurance whenever there are any changes.
Finally, make sure to keep your Zocdoc profile updated with your insurance information, so we can keep sending in-network patients your way.
Confirm coverage before an appointment with Insurance Checker
Of course, the best way to avoid an awkward situation is for patients to avoid booking an out-of-network appointment in the first place. The first step: patient education. Ask your patients (and prospective patients) to book appointments with you via the Zocdoc app, and make use of our new Insurance Checker tool when they do so.
Insurance Checker scans a patient’s insurance card to analyze their coverage and network, so Zocdoc can pair them with doctors in their network who are currently accepting new patients — no need to call office after office to find the doctor they need.
Taking just a few minutes to keep your insurance information up-to-date not only makes it easier for in-network patients to find you, but helps both you and your patient stay focused on their care, instead of whether their insurance will cover it.