Choosing the Right Financial Path

Sometimes the path is clear and simple when it comes to financial options for orthotics. The simplest being the patient has coverage, the patient’s diagnosis is considered a covered condition as outlined in the payer’s reimbursement guidelines, and the fee schedule covers the cost of the orthotic. But what if the patient is either under insured or has no coverage for orthotics? You have options!

The Patient Responsible Path

It’s unlikely that you would withhold recommendations for chiropractic care if the patient didn’t have coverage. Would it surprise you to know that some providers don’t recommend necessary orthotics to patients without coverage because of worry about the costs? If you are headed down the patient responsible or self-pay path, your team must follow established policy and procedure. Do not attempt this path without knowing all the rules regarding compliant fees, payer contract requirements, and federal regulations, such as the many components of the No Surprises Act.

In this module, you will learn

    • How to set proper fees for orthotics, whether for self-pay or insured patients
    • Why you must establish a solid Financial Report of Findings process for all patients to properly navigate the path for self-pay patients
    • Steps to ensure that patients are fully aware of their options and financial obligations
    • Scripting for explaining fees to patients for prescribed orthotics
    • Ways to offer legal and compliant payment plans to make the cost of orthotics more affordable