Nearly every solo or small group practice has faced, faces, will continue to face the same problem in all of it's variations. In our 40 years of practice, we think that we've seen it all, only to discover that another insurance configuration creates another, similar problem.
We, gently, remind our patients that, in essence they are asking us to commit fraud if we discount our fees by not collecting that which is contracted for services. We tell them that this money has ALREADY been applied to their deductible, and that our taking less from them is a felony subject to fines and jail for all parties.
We remind them that HIPPA allows them to opt to pay us in full for services going forward, and that we not report this to their insurance, but, that in doing so, they cannot have this payment reduce their deductible.
This, sadly, doesn't always work, but serves to alert patients, at least in part to the practices side of the problem, so that the don't see us as being greedy and after their money.
When patients have to assume the cost of care at the time of their visit, their eyes (and wallets) are opened to reality. We have always felt that the whole insurance house of cards would cave in. This may be the start.
