The Deadly Consequences: Forgiving Patient’s Responsibility

Sometime back prior to 1940s, most of the people in the United States paid their own medical bills. It was a “Direct Pay” where people were treated and cared for in their homes and were expected to pay for that care and treatment. Healthcare practitioners in certain cases would give essential treatment, at no charge for those individuals who could not afford to pay for services rendered.

Eventually, health insurance entered the market, easing the burden of health care costs. However applied other fundamental rules like Deductibles, Coinsurance and Copayment as a check against overutilization. However, at times this protective requirement goes against the odds of AMA Chapter 11 Opinions: AMA Code of Medical Ethics “The primary objective of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration.”

These day’s insurance carriers have been monitoring activities very closely by checking upon the collection of Deductibles, Coinsurance and Copayment. Healthcare providers are receiving letters from carriers requesting for proof that the provider has collected, or sufficiently attempted to collect the portion of fees, which is the patient’s responsibility. However, the odd side is efforts are not given and instead to maintain the patient relationship and continuity of flow; waivers are given by taking the advantage of AMA Chapter 11 Opinions: AMA Code of Medical Ethics.

It is important that healthcare providers understand that, forgiveness of patient’s responsibility could land them in trouble. Note that forgiveness or a waiver of patient’s responsibility might violate the policies of some insurers, both public and private; other insurers may permit forgiveness or waiver if they are aware of the reasons for the forgiveness or waiver. Routine forgiveness or waiver of patient’s responsibility may constitute fraud under state and federal law. Physicians should ensure that their policies on patient’s responsibility are consistent with applicable law and with the requirements of their agreements with insurers. In instances where professional courtesy discounts are given by waiving co-pays, co-insurance or deductibles for commercial insurers, these may be considered a breach of contract.

Consequently, iPatientCare introduced the software tool “Collection Management” integrated within EHR & Practice Management System module, which designates regular and non-regular paying account holders within the practice. This is one of the most essential services required by a medical practice. It makes your collections managed easily with the use of cutting-edge technology. Define your own letter’s (Collection Letter, Subsequent Letter, Final Letter, etc.) formats for soft collection approach based on the collection cycle period, set rules based on which patient would be moved from the regular account to collection account, generate letters and maintain historical information within patient chart, etc.

iPatientCare Collection Management

You have the ability to generate reports and categorize patients based on Aging, Outstanding and Time before actually moving the patient into collection module. You have the right to decide whether patient should be sent statements even though moved into collection or move the patient for hardcore collections to certified collection agency. With such effective and powerful tool, practices are sure to gain a powerful insight on their AR money and together with iPatientCare are sure to get rid of their stagnant money in a comparatively less time.

Posted in ICD-10, Practice Management solutions, Revenue Cycle Management Tagged with: , , ,

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