Author Topic: medicare patient.....turning to collection agency?  (Read 3792 times)

jennifer8055

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medicare patient.....turning to collection agency?
« on: March 06, 2014, 11:55:48 AM »
Tennessee provider.....Medicare patient w/no supplemental or secondary insurance.....patient has an $800 balance from repeated office visits/hospital visits and has stopped making payments.  After repeated statements, letters, phone calls, messages, no response......can we turn a Medicare patient to a collection agency?  If they know they have a part b deductible and 20% coinsurance for all visits/procedures done either in hospital or office, the patient knows they owe the balance.......but someone who's on a limited income or disability and probably has $40k in medical debt, is it even worth turning over or can we even legally turn it over?

any info would be greatly appreciated!

thanks! ???

RichardP

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Re: medicare patient.....turning to collection agency?
« Reply #1 on: March 06, 2014, 02:37:51 PM »
...but someone who's on a limited income or disability and probably has $40k in medical debt

How do you know this information (rhetorical question)?  And, if you know it, does the doctor also?  And if not, why not?

If the doctor knows the information you provided, why did s/he continue to see a patient they knew could not pay their bill?  Perhaps for altruistic reasons?  And, if for altruistic reasons, why would they then bill a patient whom they knew could not pay?  I presume your doctor has already been paid by Medicare?

More pragmatic questions:  How do collection agencies make their money?  (Ans. they keep a percentage of the money they collect.)  Why would a collection agency take this off your hands if it is clear the patient cannot pay?  If the Collection Agency knows they can't collect, they may charge your doctor a fee to take this collection account off your hands.  And why should your doctor pay the agency a fee to address an account that cannot be collected?

I don't see any logical path away from "write it off".  Unless your information about the patient's financial condition is suspect.

At the doctor's request, we will sometimes suspend a patient's balance owed.  With a note on the account that, if their financial condition improves, they still owe the balance.  But this is only done with folks whose finances have a likelihood of recovering.  That doesn't seem to be the case with your patient.
« Last Edit: March 06, 2014, 02:44:30 PM by RichardP »

Merry

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Re: medicare patient.....turning to collection agency?
« Reply #2 on: March 06, 2014, 04:58:46 PM »
I absolutely agree with Richard. If the patient comes back though, plans should be made for payment.

jennifer8055

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Re: medicare patient.....turning to collection agency?
« Reply #3 on: March 14, 2014, 08:46:48 AM »
...but someone who's on a limited income or disability and probably has $40k in medical debt


I was speaking hypothetically and in terms of a patient's TOTAL medical debt, not just with our office.  Our policy is if a patient has a "bad debt" balance, it must be paid in full before they come back in to be seen or make payment arrangements that the doctor agrees upon.  My doctors know about every patient's balance and whether or not they want to turn the patient over to collection.  In the end, the doctors review every account that is over 90 days w/no payments from patient for turnover.

The reason I asked the question is because around here, patient's are notorious for moving/changing addresses, phone numbers or flat out giving wrong information to a provider's office to avoid getting a bill.  The reason we turn it to an agency is they have the capabilities of "skip tracing" and tracking patient's correct information that we as a provider's office don't have the time or resources to do.

rdmoore2003

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Re: medicare patient.....turning to collection agency?
« Reply #4 on: March 14, 2014, 09:34:29 AM »
Jennifer,

to answer your question, without going aroung the world and back, yes you can send to collections.
Regina

DMK

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Re: medicare patient.....turning to collection agency?
« Reply #5 on: March 14, 2014, 10:57:54 AM »
Since it's Medicare you HAVE to try to collect it.  At least for a certain amount of time.  The doctor can always have a financial hardship policy. 

The best policy is to collect at time of service what you know is due.  And to let the patient's know right up front what their portion is.

jennifer8055

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Re: medicare patient.....turning to collection agency?
« Reply #6 on: March 14, 2014, 11:52:17 AM »
Thanks for the information.  I need to bring up the financial hardship policy with them.....I've used it at another practice I worked for and it saved the doctors time in having to review every account for possible turnover.  If other doctors are anything like mine, sometimes, they just say write it off, i know i'm never going to see it anyway, even if we do turn them over.  In that instance, we list them as "bad debt" and write it off, but keep it listed on the account, so if the patient comes back, they have to pay it along with paying their deductible/coinsurance up front for any new services.

PMRNC

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Re: medicare patient.....turning to collection agency?
« Reply #7 on: March 14, 2014, 02:07:03 PM »
I also suggest you make sure you comply with Federal Fair Debt/Collection Practices as well as any state consumer collection laws in place. You mentioned patient just stopped paying.. so you need to check regs to see when that statute of limitations clock began to tick again. A good collection agency can guide you on this. Also make sure you have followed all state collection laws even if you didn't send it to collections. ie; mini Miranda, consistent billing, etc.
Linda Walker
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