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Medicare Compliance & Reimbursement

Reimbursement Roundup:

Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment

Published on Tue Jun 21, 2011

Hint: Documented financial hardship is your key. You've heard the mantra over and over -- never waive a copay or deductible and don't offer discounts! In many cases, that mantra is correct. There are times, however, when you can offer patients with documented financial hardship a discount or waiver. Let our experts tell you the three steps to properly waiving patient fees based on financial hardship. 1. Understand the Exception to the Rule Routinely waiving deductibles and copayments can violate several federal laws and regulations, including the federal False Claims Act, anti-kickback statutes, and compliance guidelines for individual and small group physician practices. Doing so may also violate payer contracts. Even though the rule is that you shouldn't offer waivers and discounts, you can make exceptions based on financial hardship -- if you follow a few guidelines. "Waivers or discounts ... should be made only on the basis of demonstrated patient financial [...]
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