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Broker News | Vol. 9, No. 2 | January 31, 2014
Broker News | Vol. 9, No. 2 | January 31, 2014

Consumer Driven or High-Deductible Health Plans - Patient to Provider Payment

Consumer-driven health plans, also known as high-deductible health plans, have experienced a rapid growth in popularity in recent years. As more employees enroll in these plans, health care providers are discovering that many patients do not fully understand the cost-sharing aspects of their coverage, and have challenges fulfilling their financial responsibilities.

At Excellus BlueCross BlueShield, our agreements with participating providers allow them to collect payment at the time of service. We encourage providers to:

  • Confirm Eligibility/Benefits – Providers should confirm the status of the patient’s cost-sharing and benefits via our website, or by calling Customer Care.
  • Communicate Payment Policy – Providers should inform patients of their policy regarding up-front payment collection. If the patient has not met his/her deductible, he/she will be required to pay at time of service.
  • Submit Claims – Providers are required to submit claims for their patients to ensure payments process towards deductibles.
  • Provide Refunds – If it is determined on the remittance that too much money was collected, the provider (as required by law) will promptly refund the difference to the patient.

With greater financial responsibility on the patient, it is now more important than ever to ensure that employees understand all aspects of their coverage.

We appreciate the work you do in educating our employer groups and look forward to a continued partnership in providing education to our employers on this important topic.

More about High Deductible Health Plans for Employers | More about High Deductible Health Plans for Individuals

If you have additional questions, please contact your Account Consultant.


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