Otolaryngology Coding Alert

Proving financial hardship will be the key to confirming eligibility.In seminar after seminar, otolaryngologists and coders have heard the advice ad infinitum: "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 RuleRoutinely 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.In black and white: "Physicians or suppliers who routinely waive the collection of deductible or coinsurance from a beneficiary constitute a violation of the law pertaining to false claims and kickbacks," CMS says in the Medicare [...]