Using a Payer Matrix to Answer the #1 Question at Your Front Desk

By Adria Schmedthorst  |  August 4, 2015

The number one question asked at your front desk is “Do you take my insurance?”. The ability of your staff to effectively answer this question will affect both your patient collections and your patient’s satisfaction.

So, what does your patient mean when they ask whether your office takes their insurance?  What they are actually saying is “Are you contracted with my plan?”. If you are contracted with their plan, this means you have agreed to accept their allowable, which is your maximum reimbursement, including the patient’s responsibility. If you are not contracted with their plan, you can still see the patient but there is not any contract and you can set your own terms.

Whether or not you are contracted with your patient’s plan will have a significant impact on how and when you collect payment from your patient. Tweet this Kareo story

If you are contracted with their plan, you will likely have to wait for reimbursal for at least a portion of the bill but still need to make sure you collect any copays, deductible, or estimated payments at the time of service. If you are not contracted with the plan, you will need to collect either the full amount from the patient before they leave your office or set up a payment plan for the patient to pay over time.

The best way to ensure your staff can always answer the question of whether or not you are contracted with the patient’s plan is through the use of a payer matrix. A payer matrix is a document listing all of the plans you are contracted with, any variations that could result in confusion, and often the most common plans with whom you are not contracted.

Example of a Payer Matrix:

 

Payer

 

Plan Name

 

Contracted Y/N

 

Notes

 

BCBS

 

Superior

 

Y

 

BCBS

 

BCBS

 

Health

 

Y

 

May also say “XYZ”

 

BCBS

 

Wellness

 

N

 


Keep your payer matrix at your front desk and your staff can easily answer your patient’s number one question, putting their mind at ease and making sure that your patient collections run more smoothly.

Looking for more tips to improve patient collections? Download, 5 Steps to Perfect Patient Collections.

Comments

More Articles Like This..

Management | Article

You know the saying, “You only get one chance to make a first...

By Adria Schmedthorst | 03/24/15
Growth | Article

Every new business needs a business plan, including a medical...

By Adria Schmedthorst | 06/24/15
Growth | Article

Starting a new medical practice is an exciting time but it also comes...

By Adria Schmedthorst | 07/24/15