Financial Policy Medical Associates Financial

Financial Policy

Medical Associates Financial Policy

At Medical Associates, we strive to provide the best medical service possible. For us to provide the best health care possible for our patients, we must be able to recover our costs effectively. We have created this financial policy to assist with this, while simultaneously meeting your need for service and confidentiality. We strive to conduct our billing and collections operations with a high degree of integrity. You can always expect to be treated with respect by our professionals. It is important, however, for you to understand our financial policy, to ensure complete satisfaction. Please read the following carefully. Our front desk staff can answer any questions you may have regarding our financial policy, so feel free to ask if you are unsure about anything.

Billing

At a matter of course, most services will be billed and paid for at the time of service. In some cases, there will be outstanding payments for procedures, injections/medications or other items. These will be tabulated and billed after the visit. The invoice will be due 30 days from the date of invoice (Valerius, 2008)

Insured Patients

For patients who have coverage with an insurance provider, we will bill the insurance company directly for the expenses for which they are liable. This is a service we provide for your convenience. It does not guarantee that the insurance company will cover the expense. Patients will only be billed for costs incurred that the insurance company does not provide. Deductibles and copayments will be made at the time of service.

It is important to remember that your insurance contract is an issue between you and your provider (Valerius, et al., 2008). We are not liable for unpaid or denied claims. If the insurance company declines full or partial payment, we will contact you to inform you of this. We will then also send an invoice to you.

You will be required to settle the bill within 45 days of the invoice date (PCC.com, no date).

Medicare Patients

For patients who have coverage under Medicare, Medical Associates Inc. will only bill patients directly for those expenses not covered by Medicare, including coinsurance and deductibles. As a service to you, we will bill Medicare directly for the expenses that they cover. We will inform you of which services are not covered prior to rendering that service (Valerius, et al., 2008).

Outstanding Balances

In order to maintain service, you must keep your account with us current at all times. Any balances not paid within 180 days will be considered delinquent and referred to an outside agency (Napa Valley Orthopaedic, no date). Under certain circumstances, we may be able to facilitate special payment arrangements.

Special Arrangements

However, such arrangements need to be made with our office manager while the account is in good standing. Once the account has been sent for collections, no special arrangements can be made. The specific nature of any special arrangements made will depend on your individual circumstances and the ability of this office to facilitate your needs. Medical Associates cannot guarantee that we will be able to provide any sort of special arrangement.

If the event that a special payment arrangement is made between you and Medical Associates Inc., a contract will be drawn up by our staff explicitly outlining the terms of the arrangement. Any failure to adhere to these terms will result in the account being sent to an agency for collections.

Payment Options

At Medical Associates, we provide you with a number of payment options. We accept cash and credit/debit cards from Visa, Mastercard and American Express (Valerius, et al., 2008). Due to a high incidence of fraud, we are unfortunately no longer able to accept checks or money orders. We appreciate that this may cause some inconvenience, but we can no longer bear the risks associated with those particular payment methods. For credit or debit card payments on third party cards (i.e. family members) we will require that the third party be present at the time of payment.

Cash Payments

If you pay in cash, we will issue you a receipt (Snyder, 2006). You must keep this receipt as record of your payment (Napa Valley Orthopaedic, no date).

Prepayments

If you have prepaid for services, and it is found that you have overpaid, we will require a written request from you for a refund. Once the written request is received, we will pay within 30 days (PCC.com, no date). If you paid by credit card, we will issue the refund to your card directly. If you paid cash, we will issue you a check.

Part B:

This policy is ideal for a small generalist office.

The policy should outline the Medical Associates position clearly, so that the patient has an understanding of how billing and collections work from our end. This is important because of medical offices are somewhat unique in this regard compared to other businesses. The multiple means of payment, often for a single bill, necessitate this written explanation for the patient.

The main objective of the financial policy is to effectively communicate the means and methods of payment to the patients. Not only should it clarify the role of the office, but it should also clarify for the patient their role as well (PCC.com, no date) the financial policy I have developed is broken down into different sections by payment type. Some financial policies I have encountered are broken down by payment timing (i.e. For Expenses Due Immediately, etc.). I felt that this method made sense from the office's point-of-view, but not from the patient's. Patients tend to view themselves in terms of being insured, Medicare or uninsured. Thus, by breaking down the financial policy by payment type I feel the policy becomes easier to understand from the patient's perspective.

The financial policy uses clear verbiage. It is important that the language be unequivocal, because one of the objectives of a financial policy is to outline for the patient precisely what their role is. There should be no ambiguity. Thus, I have imbued the policy with clear language. When the terms are strict, that is outlined clearly.

The financial policy also benefits the staff as well. It provides them with a clear framework for dealing with patients, particularly those who would claim ignorance of the office's policies. Thus, the financial policy specifies clearly the means for payment, the time frames for payment, the responsibilities of insured patients if the insurance companies denies payment, and when the outstanding balance will be sent to a collections agency. With these items stated clearly in the financial policy, the staff can then feel confident when explaining policy to patients, particularly those who are filing a complaint, or who appear to be in violation of some of the terms set out in the financial policy.