Where it is not precluded by your payer contracts for example, there may be a clause that says you will never charge that payer any more than you charge another payerthe best way to reduce the burden on these individuals is to charge them less.
If you have any kind of relationship with your referring physicians, discussing and overcoming the issue of collecting a copay should be easy. Cigna then countersued the provider for potential injunctive relief under certain ERISA laws, and the court found there was merit for the countersuit, so Cigna was able to attempt to obtain damages for unjust enrichment and intentional tortious interference with contractual relations.
Courtesy Calls Follow-up on all outstanding overdue self-pay balances.
Having a credit card payment option significantly improves the likelihood of payment, and merchant banking costs are quickly surpassed by the increase in payments. In a recent federal court case, a provider sued Cigna for failing to pay out-of-network claims. It is very important that you have a policy in place that addresses this potential scenario, including items such as: For example, if you require a deposit prior to a procedure or surgery, be sure the patient is informed in writing at an earlier visit or in your pre-visit forms.
You can help your staff to collect with confidence with these tips: While some front offices may find it easier to simply mail a statement after the visit, there are usually hidden costs associated with this. In cases involving the Department of Justice, the powers that be have stated very clearly that the practice of routinely waiving deductibles and copays can be a violation of the Federal Anti-Kickback Statute.
People have no problem shelling out cash for gym memberships, personal training sessions, or special classes. Ensure that front desk staff are trained to determine the correct amount of the copayment, deposit or amount due, so that they can ask for the amount with confidence.
Finally, set the standard with both patients and your staff that collecting amounts due at the time of service is expected for every visit where it applies, support your employees in their collection efforts, and enforce the policy consistently.
Collecting up front is also easier for the patient.
Give them verbiage to use or a simple script along the lines of: Avoid uncomfortable conversations later. In this manner, the patient is receiving a reduced billing for the entire episode of care.
How would you like to pay for that this morning? Do you really want to represent yourself that way? What the policy is for patients who arrive unwilling or unable to pay a deposit or balance due, Who will handle these patients, If you will allow a copayment grace for patients, how many times it can be used, and what the staff should do if a patient surpasses the limit.
What about financial hardship circumstances?MBL Chapter 14 Patient Billing & Collections. STUDY.
PLAY. both patients and the practice staff.
A good financial policy is clear to _____ collection of copayments deductibles past due balances do not cover collection of copayments, just surgical costs ANSWER: all of these are covered collect overdue accounts.
Copayments, coinsurances, unresolved balances—oh my! Any one of these can cause headaches for healthcare providers, but as healthcare reform efforts shift more and more financial burden to insurance beneficiaries, today’s practitioners are.
Further inform patients by posting a courteous but conspicuous sign indicating that copayments and amounts due are required by the patient’s contract with the insurance company, and expected at the time of service. Legal Compliance: One More Reason to Collect Patient Deductibles and Copays Collecting coinsurance, copays, and deductibles upfront is an important piece of the effort to accurately value the services we provide.
Scripts to help your practice collect patient payment at the time of service payment policy to collect the appropriate payment due from the patient at the time services are rendered.
This may only be your copayment and deductible amounts, but we do ask for payment at prepare your staff to collect payments at the time of service. Collection of a patient’s copayment, deductibles and any past-due balances should be addressed; as should payment for services that are not covered by a patient’s insurance company.
An effective policy should address how a practice handles prepayment for services they will provide and also any possibility for payment arrangements of unpaid %(1).Download