Case Management

CMW Tip of the Week: Discounts to uninsured or underinsured patients

Case Management Weekly, April 8, 2009

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Hospitals may discount services to uninsured and underinsured patients who are unable to pay their hospital bills. According to the Office of Inspector General guidance for providing discounts, hospitals:

  • Should reflect full uniform charges on the Medicare cost report and inform the Medicare administrative contractor that it has reported its full charges
  • Can forgo collection efforts aimed at a Medicare patient if the hospital documents the patient is indigent or medically indigent
  • May claim discounted amounts as Medicare bad debt after determining that no source other than the patient is legally responsible for the unpaid deductible and coinsurance.
  • Can determine their own indigent-care criteria if they uniformly apply it to Medicare and non-Medicare patients

This tip was adapted from the Compliance Program Effectiveness Handbook. For more information on how to order your copy, visit the HCMarketplace.

Have a tip or tool you’d like to share? Or maybe a question for our experts? E-mail it to editor Julie McGinley at jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!



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