How to Avoid a Potential Negative Review

As a doctor, you have a unique and fragile opportunity to help your patients navigate their insurance plan. Do it right, and you’ll be their hero.

You have this opportunity because you share some common interests with your patients. You both want a positive health outcome, and you both have a financially adversarial relationship with the insurance companies you deal with.

Insurance companies are in the business of keeping payments to your practice low while keeping premiums they collect from your patients high.

Those premiums are not insignificant. According to a study by the National Conference of State Legislatures, the average monthly health insurance cost (including vision, medical and dental) is over $467 for a single person, and over $1,300 for a family of four.

Your patients are acutely aware of these costs. They want to get the most out of their expensive plans – and it’s within your power to help them.

You just have to take a few simple steps to cement yourself as a true champion in the mind of your patient; you can be the practice who is helpful and knowledgeable of insurance rules and loopholes. The flip-side is, you’re also a few steps away from appearing unhelpful and disinterested.

I recently discussed the issue with a patient who had a bad experience with their doctor.

Jane* went to get a check-up,  and opted for a more expensive (but more convenient than the alternative) procedure after hearing that her insurance “may” fully or partially cover it.

After the procedure was completed, she was presented with the bill and found that insurance covered none of the expense. “They told me it wasn’t medically necessary,” Jane said.

She was irritated that the doctor’s staff seemed disinterested in whether she would have to pay out of pocket for the procedure, and didn’t go through the additional steps to see how much, if any, of the expense would be covered.

Jane said, “I wouldn’t have opted for the more expensive procedure if they hadn’t told me it may be covered. I was annoyed.”

In defense of the practice, they’re under no obligation to spell out insurance terms to their patients – and patients, of course, should verify what’s covered and what’s not.

But consider an alternative outcome – where the practice’s staff told Jane that while the procedure “may” be covered by insurance, it’s likely that it wouldn’t be, and the total out of pocket cost would be $178. Maybe the staff member could have recommended a cheaper alternative procedure.

Which practice do you think Jane would be more likely to return to, refer to friends and family or leave a positive review for?

Which practice is likely to get the dreaded “negative online review?

The skill of the doctor or the treatment provided isn’t an issue in this case, but the doctor could receive a scathing review anyway.

So, what can your practice do to ensure optimal experiences when dealing with patients and their insurance plans?

1.       Be able to answer basic questions.

Your practice’s staff should be knowledgeable enough about various accepted insurance plans to answer basic questions about coverage. In the event that they don’t know the answer, staff should always be straightforward in how they respond to a question about what’s covered and what’s not covered. Always err on the side of caution and answer questions with something along the lines of, “I don’t know if that procedure is covered, but if it’s not covered it will cost you $X out of pocket.”

Even better: If the option is available, discuss alternative options the patient could take advantage of that may be covered by insurance.

2.       Be upfront about billing procedures.

Always be crystal clear about your practice’s billing procedures. While you can’t control the insurance companies, you can be very up front about how much, when and in what matter your patients are expected to pay you. Every staff member should understand your billing procedures inside and out. A surprise bill or sticker shock over how much you charge for a procedure or service should be avoided at all costs (no pun intended).

3.       Inform patients of requirements or follow-ups.

If your patient’s insurance requires any special follow-up forms or reimbursement, take time to remind them of that fact, and be prepared to point them in the right direction on how to fulfill those terms so they get the best possible financial outcome.

These three steps can help you avoid negative online reviews while at the same time positioning yourself as a real advocate for your patient’s health as well as their checkbooks.

Further Reading:

If you’d like more information on how to deal with negative reviews with some specific ideas on what you should do to counteract them, you can download a free white paper on the subject.
Download “How to Combat Negative Online Reviews” to get detailed instructions on dealing with negative reviews, as well as when and how you should respond.

*Patient name has been changed to protect confidentiality