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Are you letting outside
influences keep you from
THRIVING in Private Practice?
www.practiceonyourterms.com
Are you worried you won’t get paid
for a patient visit because of their
deductible?
Question 1:
The real problem is that you don’t
have a proven process for handling
patients with high deductibles.
If this sounds like you:
When you implement this
proven process:
- KEEP more of the money you earn
- STOP paying commissions to billing
companies and collections agencies
- IMPROVE patient loyalty
How to solve the 

HIDDEN
problem with 

Super High Patient
Deductibles
“I owe how much $$?
I wasn’t expecting to pay
that. I can’t.”
“Oh Um OK…I guess
we can we just bill you
later..”
#%*!
www.practiceonyourterms.com
The Patient Check-In
Patients are simply unprepared
to make high deductible
payments up front
www.practiceonyourterms.com
Urgent Care Hopping
www.practiceonyourterms.com
Wait Until They Need
Emergency Care
[An ambulance ride costs $3,421]
www.practiceonyourterms.com
Take Advantage of 

Disorganized Medical Offices
“Oh Um OK…I guess we
can we just bill you later..”
[$215,000 per year goes uncollected]
What is your biggest problem
with getting patients to pay?
www.practiceonyourterms.com
80%
20%
Do you think your doctor should 

discuss the cost of recommended
treatments with you ahead of time,
or don’t you think that’s necessary?
wish they would discuss
don’t think it’s necessary
www.practiceonyourterms.com
Will your patients pay their high
deductibles UP FRONT?
What I learned from 

over 1,000 awkward 

conversations with 

patients about money.
1. Be Firm & Fair
2. Show Empathy
3. Collect Half Upfront
How It Works
Clear
Financial
Policy
Pre-Code
Patient
Visit
Estimate
Total Visit
Cost
Collect
Half of
Amount Due
Set Up
Payment
Plan
1 2 3 4 5
+/-
The“FECH”System For Handling 

High Deductibles
How to solve the HIDDEN problem with 

Super High Patient Deductibles
Establish Clear
Financial Policies
01
Clear Financial Policy
The“FECH”System For Handling High Deductibles
1
How to solve the HIDDEN problem with 

Super High Patient Deductibles
Pre-Code the
patient visit
02
Pre-Code Patient Visit
The“FECH”System For Handling High Deductibles
E&M Procedure Code Description Expected ReImbursement
99204 Office Outpatient Level 4 / New Patient $164
Total > $164
Patient Time of Visit Payment Worksheet
Get this number from Medicare Fee Schedule for your baseline
2
How to solve the HIDDEN problem with 

Super High Patient Deductibles
estimate the
total visit cost
03
+/-
Estimate Total Visit Cost
The“FECH”System For Handling High Deductibles
+/-
$25 $139 $164
Co-Payment Expected Allowed Amount
=+
Total Amount Due
$164 - $25 gives us the $139 allowed reimbursement.
This is how it will be calculated on the Claim report 

you get back from the insurance company.
Patient Time of Visit Payment Worksheet
3
How to solve the HIDDEN problem with 

Super High Patient Deductibles
collect half of
the total amount
04
Collect Half of Amount
The“FECH”System For Handling High Deductibles
$25 $139 $164 $94
Co-Payment Deductible
=+
Total Amount Due Collect Half
Step 1 - $139 / 2 = $69
Step 2 - $69 + $25 = $94
Patient Time of Visit Payment Worksheet
4
How to solve the HIDDEN problem with 

Super High Patient Deductibles
set up a payment plan
for the remainder
05
Set-Up a Payment Plan
The“FECH”System For Handling High Deductibles
$25 $139 $164 $94
Co-Payment Deductible
=+
Total Amount Due Collect Half
You Agree to Pay the Remainder in 3 Monthly Payments of $24 with a credit card on file
Patient Time of Visit Payment Worksheet
5
Does The Patient Have Eligible 

Coverage for Scheduled Visit?
Does Patient Have
Remaining Deductible?
ADD Co-Payment, Deductible, 

and Co-Insurance to 

Amount Due
ADD Co-Payment 

and Co-Insurance to 

Amount Due
Notify Patient and
Discuss Cash Payment
Options
(3 Days Before)YES NO
YES NO
Patient Payment Collection Decision Tree
Use Worksheet to Calculate Amount Due
If Total Amount Due is
$10 - $175
If Total Amount Due is
$175-$300
If Total Amount Due is
$300+
Collect Full Amount 

Due at Time of Visit
Collect Half of Amount Due at
the Time of Visit
Offer a Payment Plan 

with Card on File
www.practiceonyourterms.com
What if the PATIENT gets
FRUSTRATED and won’t pay?
The Patient Says: You Respond With:
“I’ve never had to pay now;
can you just bill me after I get
home.” “We have begun collecting deductible
payments up-front.
This allows you to learn about your
estimated costs and allows you to make
a payment now that will go toward your
bill on the back end. Would you like to
pay by cash, check, or credit card.”
Online Training: How to Handle the Hidden 

Problem with High Patient Deductibles
If you are not following a system for handling high patient
deductibles, what you are going to learn will change your
practice overnight.
Reserve A Seat!
PRACTICEONYOURTERMS.COM

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The Hidden Problem with High Deductible Patients

  • 1. Are you letting outside influences keep you from THRIVING in Private Practice?
  • 2. www.practiceonyourterms.com Are you worried you won’t get paid for a patient visit because of their deductible? Question 1:
  • 3. The real problem is that you don’t have a proven process for handling patients with high deductibles. If this sounds like you:
  • 4. When you implement this proven process: - KEEP more of the money you earn - STOP paying commissions to billing companies and collections agencies - IMPROVE patient loyalty
  • 5. How to solve the 
 HIDDEN problem with 
 Super High Patient Deductibles
  • 6. “I owe how much $$? I wasn’t expecting to pay that. I can’t.” “Oh Um OK…I guess we can we just bill you later..” #%*! www.practiceonyourterms.com The Patient Check-In
  • 7. Patients are simply unprepared to make high deductible payments up front
  • 9. www.practiceonyourterms.com Wait Until They Need Emergency Care [An ambulance ride costs $3,421]
  • 10. www.practiceonyourterms.com Take Advantage of 
 Disorganized Medical Offices “Oh Um OK…I guess we can we just bill you later..” [$215,000 per year goes uncollected]
  • 11. What is your biggest problem with getting patients to pay?
  • 12. www.practiceonyourterms.com 80% 20% Do you think your doctor should 
 discuss the cost of recommended treatments with you ahead of time, or don’t you think that’s necessary? wish they would discuss don’t think it’s necessary
  • 13. www.practiceonyourterms.com Will your patients pay their high deductibles UP FRONT?
  • 14. What I learned from 
 over 1,000 awkward 
 conversations with 
 patients about money. 1. Be Firm & Fair 2. Show Empathy 3. Collect Half Upfront
  • 15. How It Works Clear Financial Policy Pre-Code Patient Visit Estimate Total Visit Cost Collect Half of Amount Due Set Up Payment Plan 1 2 3 4 5 +/- The“FECH”System For Handling 
 High Deductibles
  • 16. How to solve the HIDDEN problem with 
 Super High Patient Deductibles Establish Clear Financial Policies 01
  • 17. Clear Financial Policy The“FECH”System For Handling High Deductibles 1
  • 18. How to solve the HIDDEN problem with 
 Super High Patient Deductibles Pre-Code the patient visit 02
  • 19. Pre-Code Patient Visit The“FECH”System For Handling High Deductibles E&M Procedure Code Description Expected ReImbursement 99204 Office Outpatient Level 4 / New Patient $164 Total > $164 Patient Time of Visit Payment Worksheet Get this number from Medicare Fee Schedule for your baseline 2
  • 20. How to solve the HIDDEN problem with 
 Super High Patient Deductibles estimate the total visit cost 03 +/-
  • 21. Estimate Total Visit Cost The“FECH”System For Handling High Deductibles +/- $25 $139 $164 Co-Payment Expected Allowed Amount =+ Total Amount Due $164 - $25 gives us the $139 allowed reimbursement. This is how it will be calculated on the Claim report 
 you get back from the insurance company. Patient Time of Visit Payment Worksheet 3
  • 22. How to solve the HIDDEN problem with 
 Super High Patient Deductibles collect half of the total amount 04
  • 23. Collect Half of Amount The“FECH”System For Handling High Deductibles $25 $139 $164 $94 Co-Payment Deductible =+ Total Amount Due Collect Half Step 1 - $139 / 2 = $69 Step 2 - $69 + $25 = $94 Patient Time of Visit Payment Worksheet 4
  • 24. How to solve the HIDDEN problem with 
 Super High Patient Deductibles set up a payment plan for the remainder 05
  • 25. Set-Up a Payment Plan The“FECH”System For Handling High Deductibles $25 $139 $164 $94 Co-Payment Deductible =+ Total Amount Due Collect Half You Agree to Pay the Remainder in 3 Monthly Payments of $24 with a credit card on file Patient Time of Visit Payment Worksheet 5
  • 26. Does The Patient Have Eligible 
 Coverage for Scheduled Visit? Does Patient Have Remaining Deductible? ADD Co-Payment, Deductible, 
 and Co-Insurance to 
 Amount Due ADD Co-Payment 
 and Co-Insurance to 
 Amount Due Notify Patient and Discuss Cash Payment Options (3 Days Before)YES NO YES NO Patient Payment Collection Decision Tree
  • 27. Use Worksheet to Calculate Amount Due If Total Amount Due is $10 - $175 If Total Amount Due is $175-$300 If Total Amount Due is $300+ Collect Full Amount 
 Due at Time of Visit Collect Half of Amount Due at the Time of Visit Offer a Payment Plan 
 with Card on File
  • 28. www.practiceonyourterms.com What if the PATIENT gets FRUSTRATED and won’t pay?
  • 29. The Patient Says: You Respond With: “I’ve never had to pay now; can you just bill me after I get home.” “We have begun collecting deductible payments up-front. This allows you to learn about your estimated costs and allows you to make a payment now that will go toward your bill on the back end. Would you like to pay by cash, check, or credit card.”
  • 30. Online Training: How to Handle the Hidden 
 Problem with High Patient Deductibles If you are not following a system for handling high patient deductibles, what you are going to learn will change your practice overnight. Reserve A Seat! PRACTICEONYOURTERMS.COM