Author Topic: "firing" patients  (Read 2658 times)

MJ

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"firing" patients
« on: November 10, 2009, 05:30:48 PM »
We have the standard billing practice for patient billing of three billing cycles, the second with a reminder notice and the third with notice that if not responded to we will send to collection.

The problem we are having is that after sending patients to collection, it would seem appropriate that they are not seen in our clinics anymore until they set up a payment plan with the collection agency.  We send out a certified letter letting the patient know that we will provide them with emergency care for the next 30 days, but they need to find a new provider.  Problem is ... our providers don't support us the billing department.  They are worried that there could be some legal ramification of neglect and could be sued.

I know most medical practices fire patients.  Any suggestions on how the billing department might be able to facilitate this process and get these dead beats off our books?

Pay_My_Claims

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Re: "firing" patients
« Reply #1 on: November 11, 2009, 07:31:21 AM »
i suggest finding out your legal grounds prior to having such a policy. I PERSONALLy would leave if I had received a letter like that. Emergency services for 30 days....screw the MD!!

What amounts are you speaking of? Is it the deductible??? Why not do up front collections??

PMRNC

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Re: "firing" patients
« Reply #2 on: November 11, 2009, 12:52:01 PM »
You have to check your state laws. Also If I were you I would NOT provide this service because as you have stated there could be serious legal ramifications. Leave the ultimate decision to the provider on the actions taken for accounts in collection. That really is a clinical / provider issue and should NOT be handled by the billing department at all. If it were me I would merely do my part and leave the practice to continue as they see fit with my recommendation they seek legal advice on dismissal of a patient in their state, there are very specific standards set for this.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: "firing" patients
« Reply #3 on: November 11, 2009, 01:24:51 PM »
You have to check your state laws. Also If I were you I would NOT provide this service because as you have stated there could be serious legal ramifications. Leave the ultimate decision to the provider on the actions taken for accounts in collection. That really is a clinical / provider issue and should NOT be handled by the billing department at all. If it were me I would merely do my part and leave the practice to continue as they see fit with my recommendation they seek legal advice on dismissal of a patient in their state, there are very specific standards set for this.

I agree with you. Also dropping a medical client after 90 days is tacky to me.

PMRNC

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Re: "firing" patients
« Reply #4 on: November 11, 2009, 06:30:59 PM »
I don't think it's tacky if the patient is delinquent and as long as the rules/laws are followed. Doctors are in business too. If you didn't pay your mortgage in 90 days you would be sent a letter and quite possibly an ACT 91 which is just about the same thing (one step before foreclosure)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: "firing" patients
« Reply #5 on: November 12, 2009, 07:12:54 AM »
that is apples and oranges.

PMRNC

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Re: "firing" patients
« Reply #6 on: November 13, 2009, 08:03:00 AM »
No, I don't think so. That's part of overall problem with the healthcare system. Our doctors are so heavily regulated they don't get to be a "BUSINESS", so when it comes down to following the law and acting like a business, no one wants to give them that. If they follow proper legal guidelines, they have every right to dismiss a patient. I let my providers make this final decision but I will offer advice on doing so (dismissal) when I feel there are patients taking advantage of my client. It's my job to do that.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: "firing" patients
« Reply #7 on: November 13, 2009, 09:50:59 AM »
i thought you were into that hypocratic oath thing..........
I'm just saying that 90 days and you dump me is terrible. How do you let a client leave who has cancer, ALS, etc etc because of a bill? I mean its TOOOOO soon. What happens if the bill is 25.00???

PMRNC

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Re: "firing" patients
« Reply #8 on: November 13, 2009, 11:27:38 AM »
You can't just "dump" them. There is a process that involves referral to another provider and an opportunity to setup payments as well. I have a client who had a patient who owed $740 worth of $10 copay's who would always say he was going to pay.. The process we took when I took the billing was the letters, collections, and even a last chance letter to say he would be dismissed from the practice, all those correspondences included an opportunity to pay down the balance, the provider was still seeing the patient through all of this and the patient still wracked up another $200 in copay's, this actually was costing his practice. If the patient is given an OPPORTUNITY to pay down a balance with payments, and they don't, I'm sorry I do not feel the provider needs to LOSE money. On the flip side, I did some consulting with an Oncologist who would even let patients setup real tiny payment plans with no interest or late charges and still he ran balances that cost his practice money trying to collect. I do believe in the Hippocratic oath, however there has to be a line in the sand drawn somewhere.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: "firing" patients
« Reply #9 on: November 13, 2009, 02:59:24 PM »
and I agree with you i just need to argue with you to feel good....LOL