Carol looked up from her computer screen and said hello to the patient. The patient said he had an appointment with Dr. Jones at 9:00. Carol said “I need to see your insurance card.” She asked whether the patient wanted to do self-pay or run it through insurance. The patient was confused and asked whether the health insurance covered eye appointments. Carol said most people know when they come in if health insurance covers eye appointments, so the patient asked if Carol could check on the system for her, and Carol said she’d check. After 3-4 minutes of looking at the screen in silence, Carol said “We’re out-of-network. What would you like to do?” The patient asked whether that mattered, and Carol said “it’s $150 self-pay, but it could be over $300 if you used insurance,” so the patient opted for self-pay. Carol completed the transaction by taking a deposit, printing the paperwork, and directing the patient to the waiting room.
Darrell stood and smiled at his patient, introduced himself, and asked how he could help the patient. The patient said she had an appointment with Dr. Smith at 9:00. Darrell said “Great! If you have insurance, I’ll pull it up on my computer for you. Do you have an insurance card with you?” Darrell looked at the card and said, “Now there are two ways patients can pay for their appointment. The first is self-pay (and Darrell noted why some people to prefer that method). The other is with insurance; I checked your insurance, and it appears that your insurance does cover one exam per year, but unfortunately, our clinic is out-of-network, which means the charge will most likely be over $300 if you use your insurance. So would you prefer the self-pay option or using insurance?” The patient said she’d definitely prefer self-pay, and Darrell responded that he’d just need a credit card for payment. Darrell completed the transaction, printed the paperwork, thanked the patient for coming in, noted that a technician named Margaret would call her name within about 5 minutes, and showed the patient where she could wait. “Is there anything else I can do for you” Darrell asked. The patient said “no, thank you,” Darrell thanked her again for coming in today. The patient smiled and walked to the waiting room.
These are two simple stories that end with two questions.
Are you Carol or Darrell? Are you Good or Great?