Collecting at any cost

YARMOUTH, Maine - When provider Tammy Zelenko gets ready to close the books on her fiscal year every June, she strives to close out outstanding patient balances.

Sometimes, that means offering a discount to patients to get them to pay up.

“You'll do whatever it takes to get that money,” said Zelenko, CEO of AdvaCare Home Services in Bridgeville, Pa. “It's better than ending up writing it off or sending them to collections.”

With more patients paying out of pocket for needed home medical equipment—whether they have insanely high deductibles, no health insurance or simply struggle to meet their copays—it's no surprise that providers are more willing to negotiate, says consultant Kelly Wolfe.

“We do have a lot of providers that are more adamant about collecting,” said Wolfe, CEO of Regency Billing and Consulting. “Providers are hurting so badly, sometimes that 20% copay is their profit margin.”

It's a trend that's likely to continue, say consultants. For consumers, along with increased financial responsibility comes an increased awareness of the cost of health care. Some are willing to forgo using insurance in exchange for reduced cost of goods and services. It's already happening with physicians, they say.

“A lot of people will pay the doctors cash and the doctors are perfectly happy with that,” said billing consultant Sylvia Toscano. “For us, there's such a burden with documentation. Cash is a beautiful thing.”

Most patients want to pay, but sometimes they just need someone to cut them some slack, say providers.

“If the breadwinner lands in the hospital and there's no income coming in, you run into trouble,” said Lelia Wilkerson, a director at Heritage Medical in Burlington, Iowa. “It's not that they don't want to pay you, it's just that they are in a bad place.”