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BILLING & COLLECTIONS

Model Policy: Patient billings, collection and financial

Why you need this policy:

Doctors have every right—and need—to be paid. But getting patients to pay their bills on time is a major challenge that forces you to confront a bewildering array of regulatory requirements, managed care and insurance contracts, and ethical constraints stemming from the doctor-patient relationship.

How this policy helps you:

The centerpiece of juggling all of these requirements is to establish a financial policy that tells patients how they will be billed for the services they receive. In addition to laying the legal groundwork for billing and collection, including by a third party collection agency, a well-crafted financial policy plays a key role in providing effective communications with patients and preventing misunderstandings that can fester into nasty payment disputes.

How to use this policy:

This Model Policy is for a medical group practice and is based not on any single example but a “greatest hits”-type of amalgamation of best practices and cutting edge provisions from provider models across the United States. Of course, no two offices do all things exactly the same way. So you’ll need to modify the Policy—particularly the provisions regarding insurance—to your own circumstances, including the provisions of contracts with insurers and payers you deal with, as well as any regulatory requirements that apply in your particular state or city.

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