Wiki Employee write off - bill ins?

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LAT93

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Hello,

We are having a discussion at work regarding writing off an employees balance. Some are saying it's okay to bill insurance and just write off any patient(employee) responsibility. That way the office at least gets some compensation. The coder lead saying that it's not okay and that we cannot bill the patients (employee) insurance if we are planning on writing off the balance.

Does anyone have any resources regarding this? supporting either thought process? I'm thinking it's okay to bill insurance and write off patient responsibility (almost like charity) but I don't know if that is really okay.

Thank you in advance!!
 
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It is not ok to bill insurance and then write off the patient balance. You are then in breach of your insurance contracts. We attended an Ask Doug seminar where he goes over this information, plus it has been in many other webinars.
 
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This is probably a better question for the practice attorney and compliance department. If you are contracted with the insurance plan it may have impacts. I have seen practices which have a policy on treatment of employees and discounts, etc. I am guessing it can be done, but it's definitely a legal question. I think it *might* or possibly *could* have tax implications to the employee depending.

This is a good article too, just food for thought about confidentiality and other ethical issues. Other employees could see their records being one.
 
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I agree that any policy stating you will automatically write off balances for your employees is a very sticky compliance situation. The healthcare system I work for does NOT permit this to be done. You are permitted to write off balances for things like charity/financial hardship (with an official policy) or a rare customer service type issue. It is blanket write offs that are the biggest concern. I am fairly certain if you read through your insurance contract, you will see this is not permitted.
 
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csperoni said:
I agree that any policy stating you will automatically write off balances for your employees is a very sticky compliance situation. The healthcare system I work for does NOT permit this to be done. You are permitted to write off balances for things like charity/financial hardship (with an official policy) or a rare customer service type issue. It is blanket write offs that are the biggest concern. I am fairly certain if you read through your insurance contract, you will see this is not permitted.
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write off after billing to insurance or never bill to insurance but write off what would be the balance?
 
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It is likely against your insurance contract to charge the insurance for their responsibility and not charge the patient for their responsibility (excluding charity/financial hardship, etc.)
If your intention in the beginning is to not charge your employee, I certainly would not bill it to insurance. Even providing it completely free might be an issue, and should be directed toward compliance or an attorney.
 
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csperoni said:
It is likely against your insurance contract to charge the insurance for their responsibility and not charge the patient for their responsibility (excluding charity/financial hardship, etc.)
If your intention in the beginning is to not charge your employee, I certainly would not bill it to insurance. Even providing it completely free might be an issue, and should be directed toward compliance or an attorney.
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Thank you for your response. This is definitely something we need to look into as there have been issues regarding documentation for such visits. Now it may be more. I appreciate any links/resources anyone can provide regarding this subject. Thanks!
 
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LAT93 said:
Thank you for your response. This is definitely something we need to look into as there have been issues regarding documentation for such visits. Now it may be more. I appreciate any links/resources anyone can provide regarding this subject. Thanks!
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My recommendation for resources is:
1) Your particular provider's insurance participation contracts
2) A compliance professional or attorney with experience regarding False Claims or anti-kickback regulations. You are providing a financial incentive for your employees to receive care at your practice if the patient responsibility is routinely waived. You are also submitting claims to the insurance company that do not reflect accurate information.
Here are some of the top Google hits for "compliance issues with waiving employee medical copays":
 
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