Guest guest Posted February 28, 2012 Report Share Posted February 28, 2012 Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Wow, you are going to offer to see all your patients for a $10 copay, regardless of what is dictated by insurance contracts? And offer to write off balance regardless of what you get from the insurance company. What if you end up getting no payments from insurance, or if patients end up with no coverage, or coverage terminated after care started. I am pretty sure if you are contracted with any company, you must attempt to collect the contracted copay, as with the coinsurance. And I would also think this is not common practice, so my thoughts are probably not legal. Just my opinion. Lynda Geril, Office Manager Ocala Florida _____ From: PTManager [mailto:PTManager ] On Behalf Of dougrollptocs Sent: Tuesday, February 28, 2012 2:57 PM To: PTManager Subject: $10 copay Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS _____ size=1 width= " 100% " noshade color= " #a0a0a0 " align=center> No virus found in this message. Checked by AVG - www.avg.com Version: 2012.0.1913 / Virus Database: 2114/4840 - Release Date: 02/28/12 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Wow, you are going to offer to see all your patients for a $10 copay, regardless of what is dictated by insurance contracts? And offer to write off balance regardless of what you get from the insurance company. What if you end up getting no payments from insurance, or if patients end up with no coverage, or coverage terminated after care started. I am pretty sure if you are contracted with any company, you must attempt to collect the contracted copay, as with the coinsurance. And I would also think this is not common practice, so my thoughts are probably not legal. Just my opinion. Lynda Geril, Office Manager Ocala Florida _____ From: PTManager [mailto:PTManager ] On Behalf Of dougrollptocs Sent: Tuesday, February 28, 2012 2:57 PM To: PTManager Subject: $10 copay Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS _____ size=1 width= " 100% " noshade color= " #a0a0a0 " align=center> No virus found in this message. Checked by AVG - www.avg.com Version: 2012.0.1913 / Virus Database: 2114/4840 - Release Date: 02/28/12 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Wow, you are going to offer to see all your patients for a $10 copay, regardless of what is dictated by insurance contracts? And offer to write off balance regardless of what you get from the insurance company. What if you end up getting no payments from insurance, or if patients end up with no coverage, or coverage terminated after care started. I am pretty sure if you are contracted with any company, you must attempt to collect the contracted copay, as with the coinsurance. And I would also think this is not common practice, so my thoughts are probably not legal. Just my opinion. Lynda Geril, Office Manager Ocala Florida _____ From: PTManager [mailto:PTManager ] On Behalf Of dougrollptocs Sent: Tuesday, February 28, 2012 2:57 PM To: PTManager Subject: $10 copay Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS _____ size=1 width= " 100% " noshade color= " #a0a0a0 " align=center> No virus found in this message. Checked by AVG - www.avg.com Version: 2012.0.1913 / Virus Database: 2114/4840 - Release Date: 02/28/12 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 You cannot offer a blanket discount policy under any circumstances. Financial hardship agreements are very simple, must be specific to each patient's needs, and based on the full amount owed. For example, " I can afford $____ per visit and $_____ per month after I have completed service " You must bill at least the first monthly payment after the fact, then it's your call whether to write off the balance but you cannot commence an agreement with a write off plan or an arbitrary number. All of this said, many physicians are going " out of network " so they may charge what they want, accept what insurance pays only and make any deal they want. Not being a network provider means they are not held to those rules so they can waive a copayment and accept insurance only if they want. MOST facilities now have a tax ID for in network and another for out of network. When they call for authorization/verification they simply see which one pays the best and use that one. One PT did this when he found out he got $234 per visit as an out of network provider and $65 if in the network. Because he was not a provider he has no obligation to collect the balance between the bill and what insurance pays. Food for thought. I used to do the same thing thing because Medicare required you have a single fee schedule but workers comp paid far more. We made one of our five offices a WC provider and used their fee schedule for those and out of network patients. Our other provider was Medicare and private in network insurance. We even had a separate company that hired our employees. Why? If a disgruntled employee sued you he could gain nothing because the company he worked for was an employment agency with no assets. Doug Doug Sparks Advanced Physical Therapy Concepts / APTC doug@... $10 copay Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS _____ size=1 width= " 100% " noshade color= " #a0a0a0 " align=center> No virus found in this message. Checked by AVG - www.avg.com<http://www.avg.com/> Version: 2012.0.1913 / Virus Database: 2114/4840 - Release Date: 02/28/12 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 You cannot offer a blanket discount policy under any circumstances. Financial hardship agreements are very simple, must be specific to each patient's needs, and based on the full amount owed. For example, " I can afford $____ per visit and $_____ per month after I have completed service " You must bill at least the first monthly payment after the fact, then it's your call whether to write off the balance but you cannot commence an agreement with a write off plan or an arbitrary number. All of this said, many physicians are going " out of network " so they may charge what they want, accept what insurance pays only and make any deal they want. Not being a network provider means they are not held to those rules so they can waive a copayment and accept insurance only if they want. MOST facilities now have a tax ID for in network and another for out of network. When they call for authorization/verification they simply see which one pays the best and use that one. One PT did this when he found out he got $234 per visit as an out of network provider and $65 if in the network. Because he was not a provider he has no obligation to collect the balance between the bill and what insurance pays. Food for thought. I used to do the same thing thing because Medicare required you have a single fee schedule but workers comp paid far more. We made one of our five offices a WC provider and used their fee schedule for those and out of network patients. Our other provider was Medicare and private in network insurance. We even had a separate company that hired our employees. Why? If a disgruntled employee sued you he could gain nothing because the company he worked for was an employment agency with no assets. Doug Doug Sparks Advanced Physical Therapy Concepts / APTC doug@... $10 copay Group, Is it legal to collect a $10 copay/visit no matter what the patient's Insurance plan dictates. No matter if the insurance plan is a copay or co insurance plan. Then tell the patient that the they (provider) will write off the remainder of the patients bill, the $10 co pay is payment in full. Roll PT, OCS, FAAOMPT Ocean Springs, MS _____ size=1 width= " 100% " noshade color= " #a0a0a0 " align=center> No virus found in this message. Checked by AVG - www.avg.com<http://www.avg.com/> Version: 2012.0.1913 / Virus Database: 2114/4840 - Release Date: 02/28/12 Quote Link to comment Share on other sites More sharing options...
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