Collection of CO-Payments and Deductibles

Introduction

Date of Last Review 4/8/08
SME: Director of Financial Operations

HCPC has fiduciary responsibility to operate in a fiscally responsible manner and to strive to protect public funds. The goal of any medical facility is to provide quality patient care; however, the practice of medicine also is a business that involves collecting money from patients. Collections begin at the time of registration and the financial reviewer explains the payment policy.

It is important to inform the patient that co-payment and deductibles are due at the time of service to establish expectations of payment before the patient is discharged.

Procedure
HCPC Staff:
Inpatient
The financial reviewer will verify insurance coverage and collect applicable co-pays and deductibles.

• Patients without insurance coverage should be presented with an estimated amount of the potential hospital stay and collect a portion of the bill.
• Patients not lucid at time of admission will be contacted 2 days after admission or soon as the patient is stabilized and capable of such discussion.
• If the patient is unable to pay, information should be forwarded to the outside billing provider for follow-up before the patient is discharged.

Outpatient

• The financial reviewer will verify insurance coverage and collect applicable co-pays and deductibles at time of service.

Outside Billing Source:
The HCPC financial counselor should meet with the patient and or patient’s family prior to or day of discharge to collect any monies owed.

• If patient is still unable to pay then a payment plan should be set up.

If a payment plan cannot be set up then request all documents from patient to be able to determine the patient’s potential indigent status.

Related standards

The Joint Commission : Leadership

JCAHO MA 4
UTHSC-H Handbook of Operating Procedures

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