Effective Financial Policies and Procedures

Effective Financial Policies and Procedures

HCR/230

January 12, 2011

Effective Financial Policies and Procedures

1) What are the basic elements of an effective medical office financial policy?

An effective medical office financial policy is understood by both patient and staff. This policy explains what is expected of the patient. 1) Collection of copayments, deductibles, and past-due balances, 2) Financial arrangements for unpaid balances, 3) Charity care or use of a sliding scale for patients with low incomes, 4) Payment for services not covered by insurance, 5) Prepayment for services, 6) Day-of-service discounts to patients with financial need, 7) Acceptance of cash, checks, money orders, and credit or debit cards, and 8) Special circumstances for automobile accidents and nonassigned insurance. The financial policy is administered and signed on the patient’s first visit to a facility. The patient must read and sign the form and if they do not understand the form a staff member will assist them in doing so.

2) In what ways do medical office procedures support financial policies?

Office procedures support financial policies by always following policies. Many medical office’s state in their financial policy that if a patient does not show up for their appointment they will be charged and the office procedure supports that. Office procedures are the laws of the medical office and these laws enforce the policies within the office.

3) What are the consequences when office procedures do not support the financial policy?

Many consequences can arise if office procedures do not support the financial policy. Fraud and abuse are among these consequences because procedure is not followed. The most common types of fraud and abuse are unbundling charges, billing for equipment or services that are never provided, and upcoding charges to receive more money. Managing the revenue cycle will ensure timely receipt of payment if this is not done then...