🏛️ Policy & Payers

📈 Business & Tech

⭐ Just for Fun

The “One Big Beautiful Bill” (OBBB) is already reshaping how patients pay for care. For independent dermatology practices, the most noticeable shift is that patients, not insurance carriers, are now responsible for a larger share of their visit costs.

The legislation leans heavily into expanding Health Savings Accounts (HSAs) and high-deductible plans. This makes the payment process feel more like other out-of-pocket healthcare experiences, where patients are often spending their own pre-tax dollars rather than relying on low co-pays and comprehensive coverage. 

For independent practices, this means more of the financial responsibility now happens directly with the patient at check-in.

Industry data from MGMA shows practices putting more emphasis on patient responsibility and point-of-service collections. An October 2025 MGMA stat poll found that two-thirds of medical group leaders reported their patient balance collections were holding steady or improving compared to the prior year — a sign that practices are already adapting to higher levels of patient responsibility.

This shift accelerates a trend many practices are already managing. The key is to stay ahead of the workflow changes required to support it. 

With changes to Medicaid enrollment and the introduction of new plan types, patient coverage is likely to fluctuate more than usual. Relying on a card that was scanned six months ago may result in preventable denials.

CMS’ Medicaid eligibility policy guidance also underscores how eligibility criteria and coverage status can change, reinforcing the need for real-time verification rather than assumptions based on past information.

If a patient’s plan has shifted to a high-deductible option or their eligibility has lapsed, your team needs to know before the encounter to guide the patient correctly.

As more patients move to HSA backed Bronze plans, they become more price conscious. They are spending their own money, so they want to understand the value of the service.

Patients may call asking specifically about the cost of a skin check or a minor procedure. When the only answer the front desk can give is “it depends on insurance,” it creates friction and slows down scheduling.

It’s unrealistic to expect front desk staff to know the exact cost of every procedure, especially given insurance variability. But applying an 80/20 approach can go a long way. If the team is equipped with ballpark pricing for the most common services, such as skin checks or simple procedures, practices can set expectations, build trust, and convert more calls into appointments.

With higher deductibles, more revenue sits in patient responsibility, so timing and delivery matter. Waiting weeks to send a statement slows payment.

Practices that send bills immediately after claim adjudication and deliver them digitally through text and email get paid faster. One practice that recently adopted Clarity’s digital statements product saw a 15× increase in payments made within five days of sending the statement.

You can adapt your revenue cycle to handle these changes smoothly without disrupting the patient experience. Consider these three steps:

Refresh your eligibility workflow: Make it a standard practice to batch-check eligibility for all upcoming appointments 24-48 hours in advance. Most practice management systems or clearinghouses can automate this. Look specifically for "high deductible" flags or inactive statuses so you can address them proactively, rather than at the check-in window.

Normalize "card on file": If you haven’t already done so, consider introducing a policy that keeps a credit card securely on file for balances up to a set amount, such as $150 or $200. Framed as a convenience, this saves patients from mailing checks or logging into payment portals later. It is especially helpful for HSA patients who want payments handled automatically and tracked accurately. Just make sure it’s clearly included in your financial policies and supported by a signed patient authorization. Charging a card without proper authorization can expose the practice to chargebacks and claw backs during credit card disputes. Clear documentation protects both the practice and the patient while simplifying collections.

Update your financial scripting: Equip your phone and front desk teams with simple, transparent language for price inquiries. Having a standard "time of service" price list for common codes (like 99203 or 17000) allows your team to answer questions confidently. Transparency helps patients feel in control of their spending.

When you're ready for an expert to make your practice's billing bulletproof, schedule a strategy call with our team.

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