OLOL talking co-pays with patients

Patients at Our Lady of the Lake Regional Medical Center have been getting some new visitors lately: hospital employees who have been sent to collect the co-pay upfront.

“As you know, anytime you go to a physician you are asked to pay your co-pay up front, this is what we are doing as well,” said Cathy Guay, the Lake’s associate vice president of patient services, in an email obtained by The Advocate.

Guay went on to say many patients say they plan for the co-pay when they come to the hospital. However, Guay said guidelines are being prepared describing what the process is for “collectors.”

Barry Chambers, the Lake’s vice president of finance, said the policy was designed to make things more convenient for patients and to help the Lake reduce its bad debt.

He said the policy is not a collection effort but more of an educational one.

“We go up to their area, after they’ve received patient care … in a private setting to talk to them about any balance that they may owe after their insurance has paid,” OLOL’s Chambers said.

Laurie Sobel, a senior attorney with consumer advocate group Consumers Union, said collecting from patients in their rooms is unusual although not unheard of.

Sandra Wolfskill, finance practices director for the Healthcare Financial Management Association, said hospitals usually send someone in to talk about co-pays before the patient is discharged.

Typically, in elective surgery, a financial counselor would go to the room if the issue hadn’t been resolved before the patient was admitted to the hospital, Wolfskill said.

Chambers said financial counselors tell the patient about what their portion of the bill is, something a person might have to wait months to learn from an insurer.

The counselors also inform the patient about the Lake’s charity-care policy and help them figure out if they qualify.

Chambers said the Lake hasn’t been as successful collecting co-pays as other local hospitals or its sister hospitals in the Franciscan Missionaries of Our Lady Health System.

The hospital has seen a 30 percent jump in its bad debt and uncollectible expenses this year, mainly as a result of higher deductibles in insurance plans, Chambers said. In the past, a health plan might carry a deductible of $100 or $500 at most, but these days it’s common to see coverage where the patient has to cover the first $1,000 or even $5,000 of a hospital bill.

Chambers was in Florida and did not have the exact numbers but said bad debt and charity care, a big part of the Lake’s mission, amount to a little more than 10 percent of hospital revenue.

For the 12 months ending June 30, 2012, the Lake had patient revenue of $669.4 million in patient revenue, but that amount fell $12.8 million short of covering operating expenses, according to American Hospital Directory.

Sobel, of Consumers Union, said hospitals should discuss a facility’s charity care policy with patients, and that the bills are negotiable, something few people realize.

One of the ironies of health care costs is that uninsured patients are billed more than people with health coverage, Sobel said. But hospitals can discount those prices.