Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 NO! Do not waive co-pays or deductibles! It is not only illegal, it is highly illegal to waive deductibles. The insurers will cancel your contract and Uncle Sam will do nastier things! it is also poor business since it will be considered income " received " by your clinic, hence taxable. It is always best in the long run -- and the short run,too -- to play by the rules. We can get in trouble trying to " help " our patients in such matters. " The road to Hell is paved with good intentions! " Lucy Buckley PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 Dear Lynn Fu (AKA drpepper819@...), A few words as a professional courtesy: 1.) You have posted your message anonymously, but it would appear that cyperspace has noted your identify, or at least the identity of the email profile that you used. Please be aware of that, and the potential risk to your clinic that this has perhaps presented. 2.) If you truely have an anonymous message contact the listserve owner at ptmanager.com (pkovacek@...) and confer with him about posting such a message to the list and the circumstances under which it permissable. 3) The owner of your clinic should consult the managed care plans in question related to policies on waiver of co-pay and deductibles as an out of network provider. 4) If you are a Medicare provider please be advised of Medicare rules and regulations on this issue. The Physician Practice Compliance Report recently published an article dealing with this topic and how one clinic established a policy and procedure on waiving co-pays and deductibles under hardship: which is permissable by Medicare. Members on this listservice have a lot to offer and share in the rehab community, please appraise yourself of the rules of courtesy associated with this list and you will find that members are willing to share and help. Best Regards Beckley Bloomingdale Consulting Group, In Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 Unless I have had my head in the sand, I don't see where this is an issue. The collection of the deductible is between the facility and the patient. If the facility chooses to take a lesser payment for the care of the patient, that is their choice. The Insurance Co./HMO doesn't pay any more than they have committed to, the patient pays less and it is the facility that " loses revenue. " Mickey Bonk, MBA, PT Director, Rehab Services Children's Memorial Hospital 773/880-8370 deductible/co-payment Hi, everyone: I am a new grad therapist working for an outpatient clinic. I noticed that a lot of the patients at the clinic have high deductibles because we are not the in-network provider. Is it legal for the company to waive their deductible and/or co-payment? Thank you for any leads. Since this is a touchy issue, I am posting this message anonymously, sorry about that. Anonymous. __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 I think you need to be very careful with this. If you review your third-party regs (i.e. Medicare) you may find that they specifically preclude this type of action. They expect that any " discounting " of rates for services be done prior to billing them (Medicare) for the service. They do not allow for routine forgiving of the patient's co-pay, and do expect a facility to attempt to collect the full co-pay. SK Pt Care Coordinator RehabCenter @ RWMC deductible/co-payment Hi, everyone: I am a new grad therapist working for an outpatient clinic. I noticed that a lot of the patients at the clinic have high deductibles because we are not the in-network provider. Is it legal for the company to waive their deductible and/or co-payment? Thank you for any leads. Since this is a touchy issue, I am posting this message anonymously, sorry about that. Anonymous. __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 I believe you as a facility can not alter the agreement of the copay that is between the insurer and insuree. Jeffery R. Weiss Allegheny Valley Hospital >>> drpepper819@... 07/21/00 08:46AM >>> Hi, everyone: I am a new grad therapist working for an outpatient clinic. I noticed that a lot of the patients at the clinic have high deductibles because we are not the in-network provider. Is it legal for the company to waive their deductible and/or co-payment? Thank you for any leads. Since this is a touchy issue, I am posting this message anonymously, sorry about that. Anonymous. __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 The routine waiving of copays and deductibles with Federal Insurance plans is federal fraud. The waiving of copays and deductibles for other insurance plans is also likely fraudulent particularly if it is done without after the insurance company has been billed. lynn fu wrote: > Hi, everyone: > > I am a new grad therapist working for an outpatient > clinic. I noticed that a lot of the patients at the > clinic have high deductibles because we are not the > in-network provider. Is it legal for the company to > waive their deductible and/or co-payment? > > Thank you for any leads. Since this is a touchy > issue, I am posting this message anonymously, sorry > about that. > > Anonymous. > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2000 Report Share Posted July 21, 2000 It is a significant issue. From the payer's perspective, waiving the deductible is in effect reducing the amount charged for the service. They have agreed to pay a % of the charge of service and the patient agrees to pay a % of the charge. If the charge for service has been reduced, the payer then feels, and I would agree, that the amount should reflect a % of this reduced charge. Sullivan Division Director, PM & R Our Lady of the Lake RMC Baton Rouge, LA deductible/co-payment Hi, everyone: I am a new grad therapist working for an outpatient clinic. I noticed that a lot of the patients at the clinic have high deductibles because we are not the in-network provider. Is it legal for the company to waive their deductible and/or co-payment? Thank you for any leads. Since this is a touchy issue, I am posting this message anonymously, sorry about that. Anonymous. __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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