Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 Helen,I would treat her like any other patient who refuses to pay their bill, whatever your policy is. The discount offer is now null and void. And after however many bills, send to collections and discharge from your practice. You are legally obligated to provide her with her lab test results. But you certainly don’t have to provide her with “written instructions” or interpret them. If she wants to know what to do about it she can schedule another appointment and be prepared to pay off her previous appointment or she won’t be seen. The That’s what I think anyway. From: [mailto: ] On Behalf Of Helen YangSent: Thursday, February 16, 2012 3:00 PMTo: IMP GroupSubject: should we collect? We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay.What do you think is the best next step?Thanks a lot.Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 In our office policy, we state " It is your [the patient] responsibility to make sure that our physician participates in your specific plan. It is also your responsibility to know your insurance benefits. Our office will not advise you of your benefits. If we are not able to verify your insurance eligibility because you have not provided us with your current insurance information, you may be required to pay for your visit. " Not sure what your policy states, but it should NEVER be the provider to know whether or not the patient's plan is one that you participate with. The patient should have checked that out before they saw you. Send a bill and start your collection process. No discount. And you are not obligated to provide anything but emergency services if she refuses to pay you. She is entitled to request a copy of her labs, and you can be passive-agressive. If you have an office policy that you charge for records, advise her that there is a charge for that. at least you will get something.... Good luck! We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. What do you think is the best next step?Thanks a lot.Helen -- Pratt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 I agree whole heartedly with Kathy and . Deborah Ginsburg, MDHealing Oceans Family Wellness Center Helping Families Thrivewww.healing-oceans.com Sent from my iPad In our office policy, we state "It is your [the patient] responsibility to make sure that our physician participates in your specific plan. It is also your responsibility to know your insurance benefits. Our office will not advise you of your benefits. If we are not able to verify your insurance eligibility because you have not provided us with your current insurance information, you may be required to pay for your visit." Not sure what your policy states, but it should NEVER be the provider to know whether or not the patient's plan is one that you participate with. The patient should have checked that out before they saw you. Send a bill and start your collection process. No discount. And you are not obligated to provide anything but emergency services if she refuses to pay you. She is entitled to request a copy of her labs, and you can be passive-agressive. If you have an office policy that you charge for records, advise her that there is a charge for that. at least you will get something.... Good luck! We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. What do you think is the best next step?Thanks a lot.Helen -- Pratt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 We verify every insurance online prior to the patient's visit. If we can't verify it online we make the patient pay cash at the time of visit or reschedule until we can sort it out. Our biggest problem is at the first of the year when patients say the insurance is the same, they bring in last years card but we find that the group number has changed. We use a service called Nebo Systems to verify insurances online and it works for most of our insurances. It costs us $20/ month. I know you can go to each insurance company and verify it for free but it is nice to go to one site. Our goal is to have no insurance rejections. Larry Lindeman MDRoscoe Village Family Medicine2255 W. RoscoeChicago, Illinois 60618www.roscoevillagefamilymedicine.com In our office policy, we state "It is your [the patient] responsibility to make sure that our physician participates in your specific plan. It is also your responsibility to know your insurance benefits. Our office will not advise you of your benefits. If we are not able to verify your insurance eligibility because you have not provided us with your current insurance information, you may be required to pay for your visit." Not sure what your policy states, but it should NEVER be the provider to know whether or not the patient's plan is one that you participate with. The patient should have checked that out before they saw you. Send a bill and start your collection process. No discount. And you are not obligated to provide anything but emergency services if she refuses to pay you. She is entitled to request a copy of her labs, and you can be passive-agressive. If you have an office policy that you charge for records, advise her that there is a charge for that. at least you will get something.... Good luck! We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. What do you think is the best next step?Thanks a lot.Helen -- Pratt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 helen, are you asking a trick question? if this woman went to walmart and wanted milk she can be hauled in for shoplifting if she walked out with the milk and her card got denied at the checkout line. sigh. the world is topsy turvy. grace > > > We have a situation with a new patient. > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > What do you think is the best next step? > > Thanks a lot. > > Helen > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 Thank you all for your support. This patient insisted that it was entirely my assistant's fault to tell them that we participate with their insurance and that if she had known she would have to pay, she would have not come.Another patient has a policy which pays $41 for one unit (15min) of acupuncture treatment and one unit only. I told her her chronic pain problem would need one hour of treatment to do it right and she would need to pay for the portion her insurance won't cover, she agreed and one hour (4 units) of acupuncture was provided and she felt much better. She paid for three units on the DOS. I did not ask her to sign any written consent. She returned two weeks later to report she had been doing better and needed one more treatment as she was getting ready for a half marathon. I told her her EOB showed $41 was going to her deductible. She wanted the same treatment so I did it for one hour. She felt even better and paid for the treatment. Now she called us to request a refund because her insurance told her I am only allowed to collect one unit (15min ) from her for acupuncture treatment. Now I wish I had asked her to sign a written consent. What's the best next step? HelenTo: From: tagabanawa@...Date: Fri, 17 Feb 2012 01:34:11 +0000Subject: Re: should we collect? helen, are you asking a trick question? if this woman went to walmart and wanted milk she can be hauled in for shoplifting if she walked out with the milk and her card got denied at the checkout line. sigh. the world is topsy turvy. grace > > > We have a situation with a new patient. > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > What do you think is the best next step? > > Thanks a lot. > > Helen > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 3 letters: ABN. Did the insurance deny the other 3 units? Why would you even bill 4 if you knew they would only pay 1? And I'm assuming you are contracted with her insurance? Pratt Thank you all for your support. This patient insisted that it was entirely my assistant's fault to tell them that we participate with their insurance and that if she had known she would have to pay, she would have not come. Another patient has a policy which pays $41 for one unit (15min) of acupuncture treatment and one unit only. I told her her chronic pain problem would need one hour of treatment to do it right and she would need to pay for the portion her insurance won't cover, she agreed and one hour (4 units) of acupuncture was provided and she felt much better. She paid for three units on the DOS. I did not ask her to sign any written consent. She returned two weeks later to report she had been doing better and needed one more treatment as she was getting ready for a half marathon. I told her her EOB showed $41 was going to her deductible. She wanted the same treatment so I did it for one hour. She felt even better and paid for the treatment. Now she called us to request a refund because her insurance told her I am only allowed to collect one unit (15min ) from her for acupuncture treatment. Now I wish I had asked her to sign a written consent. What's the best next step? HelenTo: From: tagabanawa@...Date: Fri, 17 Feb 2012 01:34:11 +0000Subject: Re: should we collect? helen, are you asking a trick question? if this woman went to walmart and wanted milk she can be hauled in for shoplifting if she walked out with the milk and her card got denied at the checkout line. sigh. the world is topsy turvy. grace > > > We have a situation with a new patient. > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > What do you think is the best next step? > > Thanks a lot. > > Helen > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 Patient is responsible for knowing their insurance. She signed a form indicating she knew she was responsible. Your assistant acted in good faith with the knowledge she had. Tell the patient she is responsible, she signed the form. And bill appropriately. The other one is also responsible. Insurance says they only pay for 1 unit not that 1 unit is all that is medically necessary. She agreed. You have the money. Don’t give it back. Make sure everybody signs an ABN. You have difficult patients. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of Helen YangSent: Thursday, February 16, 2012 8:59 PMTo: IMP GroupSubject: RE: Re: should we collect? Thank you all for your support. This patient insisted that it was entirely my assistant's fault to tell them that we participate with their insurance and that if she had known she would have to pay, she would have not come.Another patient has a policy which pays $41 for one unit (15min) of acupuncture treatment and one unit only. I told her her chronic pain problem would need one hour of treatment to do it right and she would need to pay for the portion her insurance won't cover, she agreed and one hour (4 units) of acupuncture was provided and she felt much better. She paid for three units on the DOS. I did not ask her to sign any written consent. She returned two weeks later to report she had been doing better and needed one more treatment as she was getting ready for a half marathon. I told her her EOB showed $41 was going to her deductible. She wanted the same treatment so I did it for one hour. She felt even better and paid for the treatment. Now she called us to request a refund because her insurance told her I am only allowed to collect one unit (15min ) from her for acupuncture treatment. Now I wish I had asked her to sign a written consent. What's the best next step? HelenTo: From: tagabanawa@...Date: Fri, 17 Feb 2012 01:34:11 +0000Subject: Re: should we collect? helen,are you asking a trick question?if this woman went to walmart and wanted milk she can be hauled in for shoplifting if she walked out with the milk and her card got denied at the checkout line.sigh.the world is topsy turvy.grace>> > We have a situation with a new patient.> > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay.> > What do you think is the best next step?> > Thanks a lot.> > Helen> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 this is why i dont take insurance for acupuncture at all. and this is what the ABN is for. and they can go to another acupuncturist for all i care but their insurance only pays an MD to do it. well, so be it. i would let them loose. dont get burned at the very beginning. this will wear you out quite quickly if you dont trust your gut initially. sigh. grace > > > > > > > > > We have a situation with a new patient. > > > > > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > > > > > What do you think is the best next step? > > > > > > Thanks a lot. > > > > > > Helen > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 16-oz hammer massage; apply vigorously to thumbs bilaterally. Increase dose by 2 additional digits q24h until therapeutic goal (payment) obtained.More seriously, I don't know, other than maybe take the $@ & ?!!@ to small claims court. Some people are simply no good. I agree with the general philosophy of always collecting up front unless you have a longstanding relationship and you have good reason to believe you can trust the person.Ken Thank you all for your support. This patient insisted that it was entirely my assistant's fault to tell them that we participate with their insurance and that if she had known she would have to pay, she would have not come.Another patient has a policy which pays $41 for one unit (15min) of acupuncture treatment and one unit only. I told her her chronic pain problem would need one hour of treatment to do it right and she would need to pay for the portion her insurance won't cover, she agreed and one hour (4 units) of acupuncture was provided and she felt much better. She paid for three units on the DOS. I did not ask her to sign any written consent. She returned two weeks later to report she had been doing better and needed one more treatment as she was getting ready for a half marathon. I told her her EOB showed $41 was going to her deductible. She wanted the same treatment so I did it for one hour. She felt even better and paid for the treatment. Now she called us to request a refund because her insurance told her I am only allowed to collect one unit (15min ) from her for acupuncture treatment. Now I wish I had asked her to sign a written consent. What's the best next step? HelenTo: From: tagabanawa@...Date: Fri, 17 Feb 2012 01:34:11 +0000Subject: Re: should we collect? helen, are you asking a trick question? if this woman went to walmart and wanted milk she can be hauled in for shoplifting if she walked out with the milk and her card got denied at the checkout line. sigh. the world is topsy turvy. grace > > > We have a situation with a new patient. > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > What do you think is the best next step? > > Thanks a lot. > > Helen > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 I love how concise Kathy and are. It's so easy for me at times to be too soft and think the patient is right. Their response is direct, non-inflammatory and keeps responsibilities where they should be. Love it. Thank you for being a part of this wonderful group. To: " " < > Cc: " " < > Sent: Thursday, February 16, 2012 5:24 PM Subject: Re: should we collect? I agree whole heartedly with Kathy and . Deborah Ginsburg, MDHealing Oceans Family Wellness Center Helping Families Thrivewww.healing-oceans.com Sent from my iPad In our office policy, we state "It is your [the patient] responsibility to make sure that our physician participates in your specific plan. It is also your responsibility to know your insurance benefits. Our office will not advise you of your benefits. If we are not able to verify your insurance eligibility because you have not provided us with your current insurance information, you may be required to pay for your visit." Not sure what your policy states, but it should NEVER be the provider to know whether or not the patient's plan is one that you participate with. The patient should have checked that out before they saw you. Send a bill and start your collection process. No discount. And you are not obligated to provide anything but emergency services if she refuses to pay you. She is entitled to request a copy of her labs, and you can be passive-agressive. If you have an office policy that you charge for records, advise her that there is a charge for that. at least you will get something.... Good luck! We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. What do you think is the best next step?Thanks a lot.Helen -- Pratt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2012 Report Share Posted February 17, 2012 Thank you for the suggestions., hope it is OK with you for me to "borrow" the wording in your office policy to make mine even more clear. Sometimes there are patients that just can not be reasoned no matter how clear you spell it out in the policy.Thank you all and have a great weekend.HelenTo: From: kpratt.1022@...Date: Fri, 17 Feb 2012 07:53:37 -0800Subject: Re: should we collect? Thank you. Sometimes it is good to let someone watch your back for you. Steve is much too nice..... Happy Friday everyone! Pratt I love how concise Kathy and are. It's so easy for me at times to be too soft and think the patient is right. Their response is direct, non-inflammatory and keeps responsibilities where they should be. Love it. Thank you for being a part of this wonderful group. To: " " < > Cc: " " < > Sent: Thursday, February 16, 2012 5:24 PM Subject: Re: should we collect? I agree whole heartedly with Kathy and . Deborah Ginsburg, MDHealing Oceans Family Wellness Center Helping Families Thrivewww.healing-oceans.com Sent from my iPad In our office policy, we state "It is your [the patient] responsibility to make sure that our physician participates in your specific plan. It is also your responsibility to know your insurance benefits. Our office will not advise you of your benefits. If we are not able to verify your insurance eligibility because you have not provided us with your current insurance information, you may be required to pay for your visit." Not sure what your policy states, but it should NEVER be the provider to know whether or not the patient's plan is one that you participate with. The patient should have checked that out before they saw you. Send a bill and start your collection process. No discount. And you are not obligated to provide anything but emergency services if she refuses to pay you. She is entitled to request a copy of her labs, and you can be passive-agressive. If you have an office policy that you charge for records, advise her that there is a charge for that. at least you will get something.... Good luck! We have a situation with a new patient.I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. What do you think is the best next step?Thanks a lot.Helen -- Pratt Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2012 Report Share Posted February 18, 2012 Patients are allowing the third party to confuse everyone to get out of paying for care. But physicians by signing contracts play right into their game. Steve stown, NJ > > > > > > We have a situation with a new patient. > > > > I spent an hour with a complicated new patient last week. We did not know until now that her policy which was administered by the local BCBS is no longer part of BCBS. Therefore we are not network provider and her insurance won't pay for anything. We phoned the patient and asked her to pay a discounted fee of less than $100 (for one hour new patient visit), she refused to pay anything and demanded to have me send her her lab reports with written instructions on them. No emergency on her labwork. She did sign the office policy about patient is responsible for payment if insurance won't pay. > > > > What do you think is the best next step? > > > > Thanks a lot. > > > > Helen > > > Quote Link to comment Share on other sites More sharing options...
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