After 6 months of attempting to collect a deductible balance from a patient, we have sent the balance to collections. The patient is now calling with complaints. As our contracts stand, we are required to collect all patient out of pocket expenses in full. Are there any clauses or laws that allow us to adjust the patient responsibility? Especially with the timeframe and numberous attempts to collect? We have attempted several times to get in contact with a provider rep or someone in contracts with the insurance, but have gotten no where. Please help.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Deductibles and Collections
- Thread starter SJones52
- Start date
bjmontana
Contributor
Is the patient complaining about the amount owed, being sent to collections, or some other reason? If a patient contacts us within a reasonable time frame (maybe a month or two) and indicates there is a financial hardship or other extenuating circumstance as to why they cannot pay the bill- we will usually work with them (either writing off a portion of the balance or allowing them to make smaller monthly payments, etc). However, if they were sent a final notice and did not respond to any of your statements sent over 6 months and are just now calling after being sent to collections, we would not be very likely to grant courtesy write offs at that point. If the patient is just calling to complain about being sent to collections- as long as they were properly notified of the impending collection action, then I wouldn't even consider giving them a discount. If they are in pre-collect status ,they can work out a payment arrangement with you and be removed from pre-collect but if they are in full collect I wouldn't offer any discount if they are calling to simply complain about that.
cldavenport
Guru
If the patient received several statments PLUS a pre-collection letter, it is their responsibility to contact your office to set up payment arrangements prior to going to collections. As long as the patient contacted us prior to being sent to collections, we would gladly work out a payment plan. If the patient does not make contact and is then sent to collections, from that point on, payment is due in full to us or they can contact collection agency to set up payment arrangements. That was our policy no matter how much the patient complained.
Last edited:
mitchellde
True Blue
If the patient has insurance you need to check with the carrier as to whether or not you may adjust any part of the balance owed, this is the patient responsibility portion and it is per THE PATIENT'S contract with the payer that they pay this amount, you may not adjust the terms of the patient -payer agreement.