Billing and Collections POLICY

POLICYCODE: FN 6.18

billing and collections POLICY

PURPOSE: The purpose of this policy is to describe the process used to bill patients for services received as well as outline the steps to take when collecting fees from patients.

SCOPE: The entire organization

POLICY STATEMENT: The organization shall follow consistent billing and collection procedures. Billing is done using the Medmate software system. This policy is interrelated with the following policies: AD 1.12 (“Patient Attendance”) and AD 1.13 (“Discontinuing Clinical Services”).

PROCEDURE: Payment is requested at the time of service for fee-for-service clients. Any deductible amount, if known, is requested at time of service. Medicare, Medicaid of Commercial Insurance billing is done directly to the Insurance Carrier or Managed Care Organization, as applicable.

1.Insurance claims are generated within five (5) business days of the date services were provided.

2.The following schedule is used for billing and collections activities on patient accounts:

3.Whenever a patient’s account has been turned over to collections, Billing Staff will notify the Practice Supervisor or Office Coordinator where the patient receives services. The Practice Supervisor or Office Coordinator will follow the steps listed below to formally discontinue services to the patient-in-question.

a.The patient will receive a written notification whenever his/her account is over 150 days past due and is inactivated.

b.Unless contra-indicated by the Practice Supervisor or Office Coordinator where the patient receives care, a patient will have clinical services discontinued whenever his/her account has been inactivated.

c.If a patient’s account has been inactivated for financial reasons, he/she will not be allowed to receive services at ANY service location without having resolvedexisting financial matters as indicated in Step #5 listed above.

d.A copy of the inactivation letter will be placed in the patient’s medical record.

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