It's that time of year again — no, not cold and flu season. I'm talking about the deductible reset season. This is the time of year when medical billing company owners get at least a few calls from panicked clients wondering why their practice revenue has suddenly dropped. Many worry they won't have enough money in the bank to cover their overhead. This year, January has 5 Fridays, which means that many practices will face a 3-pay-period month exactly when cash flow is at its annual low. 

As a healthcare business consultant with 35 years of experience in medical practice management, revenue cycle management, PM/EHR implementation, and business development, I've helped numerous practices and billing companies streamline processes, reduce denials, and achieve revenue growth that exceeds prior performance. I recommend several strategic steps for practice clients to take to reduce the impact of deductible reset season. One of the more challenging aspects though, beyond the drop in revenue, is the increase in patient calls and questions asking:

To help your clients navigate these conversations, I've developed a simple FAQ template. Billing companies can give this to practices to use as a handout, a waiting room poster, or a digital blast via a patient engagement campaign.

Dear Patient,

At the beginning of each year, many patients notice higher balances after a visit. This is usually related to how health insurance works — not a billing error. Below are answers to the most common questions we receive.

Why didn’t my insurance pay for my visit?
Most insurance plans reset deductibles on January 1. Until you meet that deductible, you are responsible for the cost of your visits.

What is a deductible?
A deductible is the amount you must pay out of pocket each year before your insurance begins to pay for covered services.

What is a copay?
A copay is a fixed dollar amount you pay for specific services (for example, $25 for an office visit), as defined by your insurance plan.

What is coinsurance?
Coinsurance is your share of the costs of a healthcare service. It's usually a percentage (for example, insurance pays 80% and you pay 20%) that kicks in after you meet your deductible.

What is an out-of-pocket maximum?
This is the most you will pay during the year for covered services. Once you reach this limit, your insurance typically pays 100% of covered costs for the rest of the year.

Why is my balance higher right now?
Because deductibles reset annually, patient financial responsibility is almost always higher early in the year. As you meet your deductible, your insurance will typically begin to cover more of the cost.

What can I do if I have questions about my bill?
We’re here to help. Please contact our office if you would like to review your benefits or discuss payment options.

Thank you for allowing us to participate in your care. We appreciate your understanding.

Deductible reset season is one of the most predictable disruptions in the revenue cycle — and that predictability is what makes it manageable. By equipping your clients with clear patient-facing explanations, preparing front desk and billing teams for increased questions, and setting expectations early, you can reduce call volume, improve patient trust, and stabilize collections during a financially sensitive time of year.