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Q: What type of patients do you consider self pay? What's a good way to organize financial classes?

Patient Financial Services Weekly Advisor, May 21, 2004

A: We define self-pay receivables as those balances due from patients/guarantors for hospital and physician services as a result of having no insurance or having a balance due even after insurance pays, due to coinsurance, deductibles, or noncovered services.

At our facility, we have one financial class for straight self pay (no insurance) and one for self-pay balance after insurance has paid its portion. We also have a financial class for those patients who are on payment plans. We do this so the patients on payment plans don't qualify for the bad-debt prelist and are not referred to our collection agencies. Also, the self pay after insurance patients are sequenced differently than the others so they don't qualify for bad debt the same way straight self-pays do. The three self-pay classes count as self-pay for reporting and tracking purposes.

This question was answered by Lester Poris, CPAM, manager, credit/collections, Children's National Medical Center, Washington, DC.

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