• E-mail
• Print
• RSS

Tip: Establish copay procedures

Patient Access Weekly Advisor, May 21, 2008

Want to receive articles like this one in your inbox? Subscribe to Patient Access Weekly Advisor!

Providers are generally required to have credit and collection policies, and everyon in the healthcare continuum- from the health plan to the employer who sponsors the plan- relies on the provider to collect copays, says Maria Buckley, of counsel at Nutter, McClennen & Fish, LLP, in Boston. You need to do your part.

• Most agreements that health plans have with providers require you to abide by your credit and collection policy, Buckley says. “You need to make good- faith and reasonable efforts to go after the patient copays and deductibles and follow your policies.”
• In some states, such as Massachusetts, some providers can get compensation for treating the uninsured (i.e., providing uncompensated care). “But a routine waiver of deductibles and copays doesn’t fall into that bucket,” Buckley says. “You are permitted to legitimately waive deductibles and copays on a case-by-case basis in accordance with your credit and collection policies when you have determined that somebody meets a financial means test or a percentage of federal poverty guidelines.”
• Make sure that you are abiding by filed credit and collection policies, Buckley warns. “You can’t be routinely waiving these things to bootstrap or back-door your way [toward] having preferred status- or to have a competitive advantage over similar providers or as a routine courtesy for certain people.”

  Note: This tip was featured in Revenue Cycle Management: A Best Practices ToolkitTo learn more about this book, click here.

   

   

   

   

   

   

   

   

   

   

Want to receive articles like this one in your inbox? Subscribe to Patient Access Weekly Advisor!

• Comment
• E-mail to a Colleague
• Print
• RSS
• Archive

Comments