Volunteer Sign up | By Laws | Contact Us | Reports

Accounts Receivable Billing and Collections

PURPOSE:

The following policy and procedure is to be Al-Wadood relief Corporation followed for billing and collecting of patient accounts treated at hospital operated by Al-Wadood relief Corporation. The purpose of the procedure is to establish a system whereby we will have constant knowledge of each account. It will provide a step by step procedure that will maintain constant contact with the responsible party for discharge through complete payment of the account, write-off, or charge-off.

DEFINITIONS:

Bad Debts: Bad debts are claims arising from rendering healthcare services to a patient that the hospital, using sound credit and collection policy, determined to be uncollectible from patients who have the ability to pay.

billing-alwadoodcorporationorg

Community Free Care: Community free care are charges for healthcare services that are written off based on the hospital community free care policy. A claim can be considered community free care after an investigation of the patient’s ability to pay, including non-qualification for a government program. Community free care does not include Bad Debts.

PROCEDURE:

  1. Billing
  2. In order to maintain familiarity and understanding of the patient’s account, each Business Associate is assigned a section of the alphabet. The Business Associate follows the patient from admission, for inpatients, or initial billing through the final settlement of the account.
  3. Itemized Bills: Sent to insurance, worker’s compensation, and private pay patients, upon request.
  4. If the patient has insurance coverage, the designated Business Associate will submit each claim to the patient’s insurance company, either by electronic submission or by mail.
  5. If the patient is classified Private Pay, a first time summary bill will be provided to the patient or their guarantor up on discharge of an outpatient/emergency room visit. The first time bill states their responsibility. An itemized bill is sent upon request.
  6. Monthly Statement: Sent on a cycle basis. This procedure is repeated approximately every thirty (30) days until the account is paid, considered uncollectible, sent to early out, or written off.
  1. Collection
  2. Prior to Discharge: Every admission to the hospital must have the responsible party sign a Statement of Financial Responsibility.
  3. Upon Inpatient or Outpatient Discharge: Attempt to collect MA co-pays. If the patient has insurance, collect the amount estimated that will not be paid by the insurance. It is better to over-collect and refund than to be left with an uncollectible account.
  4. After Inpatient Discharge or Outpatient Services:
  5. Collect 100% of the billed amount up on discharge for Patient accounts with no insurance coverage/ self-paying patients.
  6. For patients with insurance coverage or for patients without insurance, with a remaining balance, follow the billing procedure first with the patient bills, then with the monthly statements as follows:

After following the billing procedure with accounts where there was no payment or other action, each step is noted by the Business Associate starting here:

(1) 1st Monthly Statement-Approximately 30 days – send statement.

(2) 2nd Monthly Statement- Approximately 60 days- send statement with appropriate message.

(3) 3rd Monthly Statement- Approximately 90 days- send statement with appropriate message.

(4) Account is sent to Early Out program.

(5) IF the Early Out program is unsuccessful in setting up an acceptable payment plan in 30 days, the account will be presented back to the hospital for approval of collection write-off.

(6) Accounts are listed for Collection Write-Off- The report lists the patient’s account number, name, date of write-off, and amount of write-off.

(7) The report is presented to the Chairman, Treasurer and Board of Directors for approval at the next Board meeting.

  1. Patient accounts with insurance coverage if insurance pays and there is a balance due:

(1) 1st Monthly Statement shows the total amount of the bill, how much the insurance paid, and the balance due from the patient.

(2) 2nd Monthly Statement (if there is no payment received) is sent out with balance due. All action taken from this point on is noted by the Business Associate.

(3) 3rd Monthly Statement (if there is no payment received) is sent out with balance due.

(4) Account is sent to Early Out program.

(5) The Early Out program will work the account for 30 days. If Early Out is unsuccessful in setting up an acceptable payment plan, the account will be presented back to the hospital for approval of collection write-off.

(6) Accounts are listed for Collection Write-Off- The report lists the patient’s account number, name, date of write-off, and amount of write-off.

(7) The report is presented to the Chairman, Treasurer and Board of Directors for approval at the next Board meeting.

  1. Patient accounts with insurance coverage if insurance does not pay and/or sends a rejection notice:

(1) 1st Monthly Statement-Make note that insurance has either denied the bill or has not responded to the claim. If the latter occurs, follow up with insurance company by telephone to check on status of claim. Send monthly statement to patient with note that we have not heard from their insurance company – please contact them.

(2) 2nd Monthly Statement – If there has been no payment or other action on the account, all action taken from this point on is noted by the Business Associate. Follow Collection Procedure for patient accounts with no insurance coverage starting with 2nd Monthly Statement.

  1. On an ongoing basis, Business Associates will monitor patients who consistently do not pay their bills and yet are regularly visiting the hospital. The Business Associates will keep the Business Office Manager apprised of problem situations. The Business Office Manager will be responsible for informing appropriate persons.
  2. Financial Arrangements – Credit Policy
  3. Financial Arrangements – Following is a guide for establishment of a payment schedule for accounts.

For Amount Owed R0- R100 Expected Payment shall be R1 0 per month

For Amount Owed R100- R200 Expected Payment shall be R25 per month

For Amount Owed R200-R500 Expected Payment shall be R50 per month

For Amount Owed R500- R1000 Expected Payment shall be R100 per month

For Amount Owed $1 000 or greater 10% of balance or to be paid in full within 24-months.

If patient fails to follow through on their monthly payment agreement: each step taken is noted by the Business Associate.

  1. 1st Monthly Statement – Business Associate will remind the patient that regular monthly payments are necessary.
  2. If no payment is received, account is sent to Early Out program.
  3. General Credit Policy- Try to get the responsible party to agree to a specific payment plan. If patient states no payment can be made at this time, allow one (1) to three (3) months grace, depending on the situation. Patient must contact us at that time to inform us of the status.
  4. Community Free Care- A patient can apply for community free care. See Criteria and Plan of Action for Patient Unable to Pay policy.
  5. Write-Off Procedure – Accounts reviewed by the Business Associate, Patient Accounts Manager, Business Office Manager, or Chairman that are deemed uncollectible are reported as follows; reviewed by the Treasurer and Business Office Manager; and then presented to the Board of Directors for approval every month.
  6. Accounts to be written off to the Collection Agency, Complete and Final Write-Offs (Plain), Bankruptcy, and Community Free Care Write-Offs are listed separately.
  7. The report lists the patient’s account number, name, date of write-off, and amount to be written off, as well as the type of write-off.
  8. The Patient Accounts Manager shall note on each patient billing the amount written off, date of write-off, and type of write-off.
  9. These written-off accounts will be segregated m files listed under “Free Care”, “Plain” (Complete), and “Collection” Write-Offs.
  10. Other Items
  11. Record insurance rejections, effective dates of bankruptcy, and patient agreements to pay in the computer under the patient’s account. Each entry is dated and initialed by the individual concerned with the action taken.
  12. Check accounts in computer by Guarantor including Collection Write-Offs before signing a receipt “Paid in Full” or accepting a check marked “Paid in Full”.
  13. The Hospital will make a reasonable attempt to collect deductibles and copayments from all patients.
  14. Business Associates will track claim denials on a report and submit monthly to the Financial Services Associate. Denials will be sorted by reason, biller, and department. Supporting documentation will be given to the Business Office Manager. The Patient Accounts Manager and/or Business Office Manager will review accounts prior to write-off. The Financial Services Associate will email a report to Department Heads.

Note: Any special deviations from this procedure should be brought to the attention of the Patients Account Manager, Business Office Manager, Treasurer or Chairman.