Wiki Cash for service

[danielle0419]

We have a patient who wants to pay for her visit and not bill her insurance. Do we have to bill for insurance once we know they have insurance. Being contracted with these insurance companys and not contracted copmanys. Anyone know? Where would I get the information

 

[TTcpc]

Promoting cash for service

Hi Danielle,

At the previous organization we attempted to research this and found nothing that said that a patient can't decide to pay cash instead of utilizing their insurance. One thing to remember though is that if the insurance comes and wants to audit the record, that visit can't be included in what the insurance company is allowed to audit since it was not filed to them. In looking for information, I came across multiple articles that are encouraging patients to pay cash for visits and even offering discounts. Here is the link for one that I found in the L.A. Times that mentioned the difference in the rates for insurance paid vs patient paid....makes me want to quit using my insurance!
http://articles.latimes.com/2012/may/27/business/la-fi-medical-prices-20120527

Here's another one on Rx meds that was on the Huffington Post and my husband has actually gotten his generic meds MUCH cheaper than our insurance would have made us responsible for.
http://www.huffingtonpost.com/2012/06/18/pay-cash-to-your-doctor-s_n_1571564.html

 

[jdyoutsey]

Under HITECH a patient may request that their information not be shared with their insurance company if they pay in full out of pocket.

 

[TTcpc]

Under HITECH a patient may request that their information not be shared with their insurance company if they pay in full out of pocket.

You're correct the HITECH Act does provide provision for this, my mistake; have always been focused on the EMR implementation side. I have not had a chance to review/research this, but I am wondering how the Affordable Care Act changes will affect this since everyone will be required to have insurance, will we now be required to utilize it every time we seek care? It seems as if we are going to be made to have insurance, that we will be made to utilize it; thus basically taking away that provision of the HITECH Act. It will be interesting to see how ACA will change compliance guidelines set forth in HIPAA and HITECH and others.

 

[jdyoutsey]

twtcpc, I think that even though everyone will be required to have insurance, HHS will still be concerned about privacy. I think that patients will probably still retain this particular right to limit disclosure. The important part of this is making sure that it's documented in some way that these services aren't to be disclosed to the insurance company. It's easy immediately to not bill, etc. but years later when the insurance does an audit you want to make sure that you still don't send the information and violate the patient's rights.