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Topic: six critical elements of a complete payment policy

Ambulatory Surgery Reimbursement Update, September 30, 2008

The best way to prepare your staff members to handle patient requests for payment arrangements is to have a thorough policy in place, says Sandy Berreth, BS, RN, MS, CASC, administrator at Brainerd Lakes Surgery Center in Baxter, MN. Establish a thorough policy for cases in which the surgery center agrees to a payment arrangement with a patient.

Berreth says to include the following six critical elements in that policy:

  • A directive about all-inclusive fees
  • A facility charge and a process for development of a fee for every CPT-coded procedure
  • An advisory notice for patients of additional charges, which may include, but is not limited to:
    o Preadmission testing conducted elsewhere
    o Surgeon fees
    o Anesthesiology professional fees
    o Pathology services
    o Radiology services
    o Laboratory services

  • A notice that self-pay balances of less than $250 are due immediately upon receipt of statement or by arrangement. The notice should stipulate that after 90 days, plus a grace period of 10 days, the ASC will reassess the account, and further collection activity may occur.
  • A notice that balances greater than $250 need to be paid in full in three monthly payments or by arrangement. The notice should state that if the patient does not make a payment or establish contact with the office within 90 days of billing, further collection activity will occur.
  •  Information stating that when payment arrangements are made, a payment booklet will be sent to the patient; therefore, the patient will not receive statements regarding that account.

Editor’s note: This topic is from the September 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider.

 

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