Results 1 to 10 of 10

Medicare write offs

  1. Default Medicare write offs
    New Call-to-action
    Can a physician write off a coinsurance amount required after Medicare and Medicaid has made payment.

  2. #2
    Dover Seacoast New Hampshire
    Not categorically. Make sure you do your research first. You should have a solid financial aid policy in place before you write off any patient responsibility for which you are contractually obligated to collect.

    Medicare's Fraud and Abuse Guide's “Examples of Improper Waiver of Deductible and Copayments,” outlines, “marketing practices that may be suspect to charge-based providers” includes “(Non-) Collection of copayments and deductibles only where the beneficiary has Medicare supplemental insurance (“Medigap”) coverage (i.e., the items or services are “free” to the beneficiary,” and “Failure to collect copayments or deductibles for a specific group of Medicare patients for reasons unrelated to indigence.”
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. Default
    Thank you for the information. You verified what I had anticipated.

    Do you know how I can get an exact copy of the guidelines to show to our physicians?
    Last edited by nluppi; 08-31-2010 at 07:26 AM.

  4. #4
    Default Financial aid policy
    I am looking for a financial aid policy to adapt to our practice. The ones I have found are several pages long and require the patient to bring in proof of income. My physician feels that it is a time consuming endeavor for the staff to monitor and determine if the patient falls into guidelines. Can someone link me to a concise, practical policy? And any guidelines I should follow. Thank you.

  5. Default
    I know you asked for something that isn't pages long and your doctor doesn't want you tied up with verifying income and deciding if someone qualifies. Unfortunately, it's not that easy. You have to have something documented as to why you are forgiving patient's amounts owed or reducing them. It's the only proper way - you have to have a policy, be able to supply it to patients and be able to make a qualified determination. In order to do that, you need to be able to explain it to your patients and have an application. Here are some policies you could use to adapt your own:
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

  6. #6
    I worked for a physical medicine/rehab doctor. He required any patient that said "I can't afford my bill" to sign a legal-binding waiver and we got the pt's previous years' tax return along with their monthly utility bills. The doctor reviewed this info. One patient had over $100,000 in the bank. It pays to do legwork.
    My motto is 90 days and out the door to a collection agency and dont see the patient again until they pay.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

  7. #7
    Default write offs
    My original interpretation of the question was write off after MCR and Medicaid had made payments. I am thinking that the pt has both insurances. In my practice we call it a Medi/Medi adjustment. The patient is not responsible for anything after the two insurances have paid.
    If I read the question wrong, I am sorry

  8. #8
    New Windsor, New York
    Quote Originally Posted by sande78705 View Post
    My original interpretation of the question was write off after MCR and Medicaid had made payments. I am thinking that the pt has both insurances. In my practice we call it a Medi/Medi adjustment. The patient is not responsible for anything after the two insurances have paid.
    If I read the question wrong, I am sorry
    Don't feel bad Sandi, I read the question the same way. And...if Medicaid paid after Medicare, isn't the Medicaid payment supposed to be accepted as fulfilling the coinsurance requirements in full? Here in NY State, Medicaid will pay 20% of the 20% coinsurance after the Medicare payment, and that is complete - no further patient responsibility.


    Associate Director, Compliance Audit Program
    Westchester Medical Center Health Network
    Valhalla, NY

    Vice President - New Windsor NY Local Chapter 2019
    Past Secretary - Ellenville NY Local Chapter - 2016-17

  9. #9
    To answer this question, you need to be clear on where the patient responsibility originated.

    If the patient responsibility or coinsurance is from Medicaid, such as a patient on a spend down or sliding scale, then you need to collect the balance from the patient. All the previous suggestions for a charity/financial aid assessment/process apply.

    However, if the patient responsibility or coinsurance is from Medicare, the patient may not be responsible. You need to fully understand the Medicaid remittance.

    Many states have implemented a Medicaid "cap" where the provider cannot receive more than Medicaid would have paid for the service overall. In these instances, you may not bill the patient for the difference. But if you are an institutional provider, you can claim this in your Medicare Cost Report as Medicare Bad Debt.

    If the Medicaid payment was not capped, you should make sure that all the charge lines were paid and pay close attention to the reason code for any charge line that isn't paid in full by Medicaid.

    Does this help?

  10. Default
    This has been a super helpful thread to me too, as we need a more firm financial hardship policy in place at my current practice!

    Right now I am learning the ropes of Medicare/Medicaid, and I must admit my head spins at times. Even though my daughter is a Medicaid recipient, seeing it from the other end is wildly confusing at times.

Similar Threads

  1. Medicare write off vs pt refund
    By vanessac in forum Billing/Reimbursement
    Replies: 4
    Last Post: 10-22-2012, 09:23 AM
  2. Co-pay/Co-ins write offs
    By Tonyj in forum Medicare Regulations
    Replies: 2
    Last Post: 08-06-2012, 02:07 PM
  3. Patient Billing/Write-Offs
    By emreed99 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 04-10-2012, 03:28 PM
  4. Secondary write offs
    By Danielle in forum Billing/Reimbursement
    Replies: 1
    Last Post: 05-27-2010, 06:06 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.