POINT-OF-SERVICE-COLLECTION

Paying Doctors Upfront: Point-of-Service Collections

Over the past decade, out-of-pocket healthcare expenses have more than doubled for the average American. Many people are choosing high-deductible health plans in order to save on monthly premiums, but this change puts a higher burden on their wallets when it comes time to go to the doctor or fill a prescription. Doctors have been slow to change their internal billing practices in the past, but now they find themselves swimming in a sea of their own unpaid bills. Many providers are switching to point-of-service collections to curtail their losses, asking patients to pay for services before leaving the office. While the movement may not make everyone happy, it may be the only way to keep doctors in business.

What are Point-of-Service Collections?

There are many interpretations when it comes to point-of-service (POS) collections. Doctors and hospitals may refer to their POS collections as time-of-service, upfront, or front-end collections. In general, a provider who participates in POS collections will ask for payment of a proposed service sometime before the service is rendered, up to the time the patient is discharged or leaves the office.

POS collections ask everyone to pay, from patients who pay solely out-of-pocket to those who are insured and need to pay either a deductible, copay, or coinsurance amount. POS collections can also include prior balances or payment plan payments. Most hospitals and medical providers who conduct POS collections accept cash, checks, and credit card payments.

Why Does My Doctor Want Money Upfront?

With insurance premiums and deductibles continually rising, more and more Americans are having trouble paying their medical bills. According to the Academy of Healthcare Revenue, providers have a 70% chance of receiving payment at the time of service if they request it – but only a 30% chance of collecting it after a patient leaves the building. Since 

so many people are unable to pay their balances, many providers have started to question if they can even stay in business.

The reimbursement rates that doctors receive from insurance companies are also constantly changing. When you combine this reimbursement uncertainty with patient non-payment, many providers are left struggling to pay their office bills. Office space, utilities, technology, medical equipment, and staff are all necessary for patient care – but these items all cost money.

By moving to the POS collection model, providers are finding that they can spend less time billing patients and more time treating them. Many doctors and hospitals are even adopting payment plans as a way to help patients cover costs, similar to other industries that deliver higher-dollar products and services. While some patients may dislike the trend, it is allowing doctors to stay in business.

How Does My Health Insurance Work?

The traditional model of copays is quickly going out of style. Most patients now deal with health insurance that features either a high deductible or coinsurance – or a combination of both. Deductibles and coinsurance do not negate monthly premiums, though; they are paid on top of them.

• Deductibles      – A deductible is the amount of money a patient must pay      out-of-pocket before their insurance pays anything. These out-of-pocket      expenses include prescriptions, sick visits, hospital stays, and medical      procedures. For example: If you have a $8,000 deductible, that means that      you must pay $8,000 in medical expenses before your health insurance will      begin sharing your costs.
• Coinsurance      – Often after a patient meets their deductible, their insurance      company still only pays for a portion of their bills. Coinsurance plans      split the patient and insurer responsibility based on a percentage.      Typically, patients will have to pay for 10-20% of a service out-of-pocket      (or more) while the insurance company pays the remaining percentage.

The Bates Primary Care Policy

At BPC, we ask our patients with policies featuring annual deductibles to pay $125 on the day of their office visit. This $125 goes toward paying down the patient’s out-of-pocket costs associated with the visit and also contributes to paying down the patient’s deductible as a whole. 

We have decided to implement the $125 POS collection fee for several reasons:

1. Patient      Budgeting: The POS collection helps patients budget their medical      spending based on services needed, and it also spreads payments out when      they are still coming entirely out-of-pocket. Instead of receiving a bill      for services all at once, a patient can pay $125 upfront and then the      remainder when it is billed.
2. Office      Budgeting: Knowing that we can count on a steady revenue flow      helps us operate our office more smoothly and efficiently. Although we      still work closely with patients and their insurance policies, the POS      collection ensures at least a partial payment for services even when the      insurance company is not yet liable.
3. Insurance      Company Compliance: The agreements patients enter into with their      insurance companies are legally binding contracts. By collecting a      patient’s financial obligation, we are merely doing our part to enforce      the previously agreed-upon contractual terms.

We understand that rising medical costs can make health care seem unaffordable for some people. BPC is committed to helping our patients ease this burden in whatever way we can. With our $125 POS collection, we can save money on billing services – keeping the prices for our services down for our patients. We want everyone to receive the highest-quality care available, and we will help you with insurance claims whenever we can. If you have any questions regarding your personal insurance coverage, feel free to contact us at any time. Let BPC help with your health in well-being in 2025-2026; set up an appointment today!