Forum - Questions & Answers
Waiving copays and or deductables in select situations
What if any options are available to reduce or disgard patient balances? I understand ability to pay is one consideration. Are their other ways to reduce patient portions of the charge?
re: Waiving copays and or deductables in select situations
Caution: . It can be seen as an inappropriate and unlawful inducement or a kickback. One important exception to the prohibition against waiving copayments and deductibles is that providers, practitioners or suppliers may forgive the copayment in consideration of a particular patient's financial hardship. This hardship exception, however, must not be used routinely; it should be used occasionally to address the
special financial needs of a particular patient. Except in such special cases, a good faith effort to collect deductibles and copayments must be made. Otherwise, claims submitted to Medicare may violate the statutes and other provisions of the law.
http://oig.hhs.gov/fraud/docs/alertsandbulletins/121994.html
re: Waiving copays and or deductables in select situations
Does the same apply with commerical insurances whether contracted or not contracted?
re: Waiving copays and or deductables in select situations
Probably
re: Waiving copays and or deductables in select situations
Contracted, yes. There is typically language re: obligation to collect in the contract.