Many offices lose money by not collecting all of the money that is due to them from patient responsibilities. Some do it by choice, and others because they do not have a system for their patient billing. They do not even realize that the patients are not paying the piece they owe.
In any case, it is principal to know that you could salvage into exertion. With Medicare, it is illegal to not bill the patient for their piece, whether it is the deductible or the coinsurance. It is also illegal to bill for more than Medicare allows you to, so you must design certain you understand what the patient’s part is. If Medicare finds out that you are billing Medicare for services, but not billing the patients for the patient responsibility, you can be investigated for Medicare fraud.
Of course there are exceptions. If a patient has a financial hardship you can waive the patient responsibility, but you must document this in the patient’s chart. And you can not claim that every Medicare patient that you treat has a financial hardship. There are also other ways around this. You must bill the patient for their responsibility, but there is no law on how far you have to go to obtain it. So if you send them a patient statement and they do not pay the bill, there is nothing that says you have to send a second one. As long as you can point to that you billed them.
With commercial insurances, there is usually a clause in the contract that you impress that states you will bill patients for all copays and/or any other patient responsibility. If the insurance carrier finds that you are not charging the patients, they can contemplate it a violation of your contract with them and discontinuance your participation. They do not usually go any further than that, such as investigate for fraud, unless there are other violations going on as well.
If you have a couple of patients, friends, relatives or people with good financial difficulties that you are not charging that will probably not pain you. But if you magnificent great across the board do not charge your patients, you could obtain into some misfortune. Some people have a difficult time charging their patients. These laws are a top-notch excuse for them. “I do not want to have to charge you, but if I gather caught I could be removed from the insurance carrier’s panel or investigated.”
If you have not been charging your patients, you will be surprised how mighty your receivables can go up when you do. It doesn’t seem like mighty, but it really adds up.
Copyright 2008 – Michele Redmond
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