APPROVED BY: ADMINISTRATION
EFECTIVE DATE: January 2011
REVISION/REVIEW DATE: March 2016
The purpose of this policy is to provide direction on the Hospital’s policy to collect the balance due on patient portion of the Hospital’s accounts.
- Howard Memorial Hospital will send patient statements and detail itemized statements when requested by the patient or responsible party and when allowed by contract or regulatory statute. After proper patient, guarantor or legal authorization is provided, an attorney‘s request for billing statements will be fulfilled by sending itemized statements.
- Howard Memorial Hospital will use the same collection activities with Medicare patients as the hospital does with all other patients to stay within Medicare guidelines. All patients will be billed on a successive basis after date of service, after insurance pays or after payment denial.
- Statement cycle begins after all insurance has paid or after the automatic 60% discount is applied to an uninsured account balance. After the primary and secondary insurance plans have paid and amount due from the patient or guarantor is determined, the patient’s account will begin the billing cycle. Uninsured accounts are billed to the patient only after the automatic 60% discount is applied.
- First statement is sent to patient with request to set up a payment plan. It is the obligation of the patient or guarantor to provide a correct mailing address at the time of services or upon moving. First statement is sent to patient or guarantor no later than day 28. First Statement provides contact information for Howard Memorial Hospital’s financial assistance program.
- If no payment, second cycle statement is sent to patient or guarantor no later than day 57. Second Statement provides contact information for Howard Memorial’s financial assistance program.
- If no payment, a letter from Business Office Extension Service is sent to the patient or guarantor no later than day 88. Letter provides contact information for Howard Memorial’s financial assistance program. Deadline on the final notice is no earlier than 30 days after the date written notice is provided that account may be turned over to 3rd party collection agency.
- If no payment, Business Office Extension Service will make two phone calls to the patient between Days 89 thru 117. Business Office Extension Service will make a reasonable effort to determine if patient would be eligible for Financial Assistance or set up payment arrangement with the patient or guarantor.
- Director of Business Services or designee will review accounts to ensure that all reasonable efforts to determine FAP eligibility have been made and approve all accounts prior to assigning to a 3rd party collection agency.
- Howard Memorial Hospital will accept and process an application for Financial Assistance from a patient or guarantor that has not been determined to be eligible for Financial Assistance through Day 240 from the post discharge statement. If it is determined that a patient is eligible for assistance through Day 240, all collection efforts will cease and the Hospital will take all reasonable efforts to reverse any collections efforts already taken.
Patients with Medicare as primary and Medicaid as secondary insurance or patients with Medicaid as primary should not have statements mailed to them.
Howard Memorial Hospital holds its third party collection agency accountable for appropriate collection efforts completed on the Hospital’s behalf. The third party collection agency may take legal action including, but not limited to, telephone calls, mailing notices, skip tracing, wage garnishment and legal to obtain payment for provided medical services.
Howard Memorial Hospital will make reasonable efforts to verbally communicate with the patient or guarantor about the Hospital’s Financial Assistance Plan and how assistance may be obtained with the FAP application process before an account is turned over to a third party collection agency.
If the patient or guarantor submits an incomplete application for Financial Assistance, Howard Memorial Hospital shall suspend all Extraordinary Collection Actions and provide the patient with a written notice identifying the additional information required to complete the financial application. If the patient or guarantor fails to provide the additional information requested within 10 days, Howard Memorial Hospital may proceed with collection efforts.