The Obligation Calculator
The patient financial obligation calculator assists practices at the time of service in calculating the correct amount due using information obtained from real time eligibility mapped against the services rendered and the reimbursement matrix. For most office visits, a co-payment amount is collected. A growing number of Americans are paying lower health insurance premiums in exchange for high deductibles, taking a gamble that saving money on premiums won't put them in a tough financial situation if they seek medical care.
The best performing practices collect deductible and co-insurance amounts at the time of service. Practices often struggle to determine how much to collect or do not have the tools to calculate the amount due creating a lost opportunity to collect from the patient. We created a tool to help our clients.
Calculate the correct amount and collect it at the time of service.
4 variables in calculating the amount due by a patient:
- Location of Service and Rendering Provider
- Contract and Product (example, BCBS is network and PPO is the plan)
- Service Provided (CPT Codes)
- Real Time Eligibility Information (deductible amount, amount met, coinsurance percentage)
Select the "Calculate Allowed Reimbursement" to generate claim allowable and then "Payment Breakdown" to see how much of the allowable will fall to co-payment, deductible or co-insurance.
The Quote Tool
The Obligation Calculator also allows a practice to generate a quote "Export to Report" for future services (i.e. elective surgery) giving patients a clear understanding of the amount they will owe and the ability for the practice to initiate a payment plan to ensure the amount is paid in full prior to services being rendered. Data used to create the quote is provided by the carriers both through real time eligibility and the contracted allowable amount by service.