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collecting payments

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ruthie72:
I have a question..my provider wants to collect a fee from patients even if they do not have a copay and then submit the claim. She says we will reimburse the patient if they pay over the allowed amount..is it okay to do this? thank you

DMK:
If it's insurance, and you're contracted with the insurance company, you can ONLY collect co-pays and deductibles per their policy.  You can't take money just to be taking money.  I understand wanting to create cash flow, but it's not the legal way to do it.  When the patient comes in, check their insurance while they're there, or if possible, check it when they make their appointment so the patient knows right up front what they are expected to pay (if anything) at the time of service.

ruthie72:
That is what I have been trying to tell her, but she does not seem to understand. She keeps saying well what if they do not pay their bills??? I do not know what to do...I told her to please look over her contracts with each insurance company..How would you handle this?

DMK:
I COMPLETELY understand the doctor's point.  Some people aren't good at paying their bills, and they think the "rich doctor" can just write it off.  That's why you verify their benefits, and if you already have patient's on the same plan you will know EXACTLY the correct amount to collect so there's no surprises on either side.   And it is a good habit for people to pay something, if they're going to owe something.

For example, our office bills for only a few types of services and I have a fee schedule from the insurance companies we deal with regularly so I know exactly what each service pays.  I can quickly add up what the days services will be, calculate their deductible or co-insurance or just collect their co-pay. 

If you collect correctly at time of service after verifying benefits, you won't have any issues down the road and no huge outstanding balances.  Nowadays, MOST patients will have to pay something at the time of service since MOST policies have deductibles and co-pay or co-insurance.  The better the front desk is at educating the patient as to what their portion will be (and doing it correctly) the better the better patient relationship is.

Billergirlnyc:
I couldn't agree more with DMK. It's imperative that verifications are done before hand. It's imperative that your doctor looks over her contract as he/she doesn't want to run into issues w/any plans he/she is contracted with. And it's imperative that the front desk is educated on how to educate the patient on what their responsibilities are before they're seen. I can't tell you how many headaches this will eliminate if everyone does their part in informing the patient beforehand.

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