Creating Estimates for Upcoming Visits:

Using the patient's appointment type, create estimates for everything from new patient visits, routine follow-up, or specialty procedures.

For office visits, create the estimate using a default E/M code (e.g., 99204 or 99213) and leave it in draft form. After the patient is seen by the provider, modify the estimate with the correct E/M code and any additional services necessary.

For surgeries or procedures, create the estimate as part of the surgery scheduling process or as part of the prior authorization process. The estimate can be sent to the patient via email or text message.

Managing Deductibles and Out-of-Pocket Maximums:

In the case where two providers will be providing services to a patient (surgeon and facility), whichever entity submits their claim first will have the patient's deductible applied to their claim. To mitigate this, you can choose to zero-out the deductible if you know the facility is going to collect it and submit their claims first.

This same logic applies to patients near their out-of-pocket maximum. If the co-provider submits their claim first, they will use the rest of the patient's out-of-pocket and if your practice collected money, you will need to issue the patient a refund.

By collecting payment up front and creating estimates for upcoming visits, you can increase patient collections. Managing deductibles and out-of-pocket maximums can also help avoid refund issues. If you have any questions or encounter any issues, please contact us through the chat feature.

To learn more about patient collections, contact the Rivet support team at support@rivethealth.com.

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