See if we can request all patients who fall into the category with the 90 day grace period, bring in their premium statement for the current month.
I assume you will look at the premium statement for proof that the previous month's payment was received by the insurance carrier. Suppose the patient hasn't yet received the premium statement? And, even if they have a current premium statement, suppose they made the premium payment with a bad check that wasn't caught before the current premium statement was sent out?
Q4: Will there be any way for the doctor's office to identify these subsidized insurance accounts that are subject to the 90-day grace period? That is, will there be any way for a doctor to determine what his exposure is to the amount of money he might have clawed back?
The answer to the first part of this question is no. There is no difference in the way the insurance ID cards or benefits summaries will look. They policies are still issued by the private insurance companies, so they will have the same uniform appearance as all of the other policies these insurers administer. Some insurance companies do offer specific plans that are only available on the state exchanges, but the only way to identify them is to know the actual plan names. Since the minimum requirements of the ACA apply to all non-grandathered and non-indemnity plans, the coverage details will not be a clue either. This is by design.
QuoteThe answer to the first part of this question is no. There is no difference in the way the insurance ID cards or benefits summaries will look. They policies are still issued by the private insurance companies, so they will have the same uniform appearance as all of the other policies these insurers administer. Some insurance companies do offer specific plans that are only available on the state exchanges, but the only way to identify them is to know the actual plan names. Since the minimum requirements of the ACA apply to all non-grandathered and non-indemnity plans, the coverage details will not be a clue either. This is by design.ALL of the individual subsidized plans on the exchanges WILL be identified with the metal plan as well as the individual or family identifiers.
Here is a useful read on who will qualify for Premium Tax Credits. All Premium Tax Credits are payable in advance.http://www.cbpp.org/files/QA-on-Premium-Credits.pdfshanbull, you say you have the highest insured population of any state. Consider two things: First: as people learn how to calculate the Premium Tax Credit, you may discover that many of the already-insured in your state qualify for a Premium Tax Credit. They would be foolish to not take advantage of that if they can. Second: Many businesses are shedding their health insurance programs in any way they can, forcing the already-insured into the exchanges. That may accelerate when the one-year extension runs out for business to participate in the ACA. I think we will see many more people with Premium Tax Credits several years from now than we see now.