Dealing With a “Difficult” Patient: Part 2
Welcome to the encyclopedia of patient scripts, or “Scriptopedia,” where I’ll provide you with specific scripts that have resulted in the success of either increasing patient education or the dispensing of a product or service. This month’s column is the second in a three-part series on “Dealing With a Difficult Patient.” This month’s topic: The patient confused about their insurance coverage.
Sometimes, at check out, patients become angered when they are confused about their coverage and believe a co-payment for a returning “follow-up visit” should have been covered by their “routine” visit. To prevent this scenario, have staff explain the difference between routine vision benefits and medical insurance necessity at their check in. Then, have patients sign-off on their understanding in a document (provided right) that explains the differences.
Vision Vs. Medical Plans
If my eye doctor determines I am at risk of an eye disorder or eye disease:
• I will be made aware when additional testing and evaluation is necessary to manage my eye health and sight.
• Any testing for my benefit will be billed to my medical health insurance.
• I am aware co-payments and co-insurance are my responsibility at the time of service.
• ___________________ will submit both vision and medical claims when appropriate in order to maximize my benefits.
• Both my vision plan and medical insurance may have co-pays and deductibles, which are due at the time of service.
• For initial treatment and any prescribed follow-up treatment, my vision plan or medical health insurer determines the co-pay or co-insurance due and payable at time of service for each visit.
“Unlike your medical doctor’s office, we may accept both medical insurance and vision discount plans. You may have one or both. This document explains the difference between these two types of benefits. Both types of plans may include co-pays and deductibles, which are your responsibility, as outlined by your vision or medical provider when you elected your plan. We will answer additional questions for you as you may wish.”
Optometric Management, Volume: 49 , Issue: February 2014, page(s): 72