Collect Up Front

by  Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
March 3rd, 2015

According to Medicare regulations, you are able to collect monies owed by the patient at the time of the visit (deductibles, coinsurance and co-pays), this is also true with other commercial insurance contracts.  

Collecting monies owed by patients at the time of their visit can reduce overhead.  Of course, you must determine if the practice of collecting deductibles, co-insurances and co-pays is beneficial and suitable to the practice you work in or it would become too much work and best left to collect on the back end.  There are pros and cons to collecting monies up front.

There are several steps that need to be taken in order to do this appropriately.

  1. Confirm the patient's insurance benefits, deductibles, coinsurance and copay prior to the patient's visit.  
  2. If the patient has Medicare and there is a risk that a specific service will not be a covered benefit, be sure to obtain an ABN (Advanced Beneficiary Notice) and be sure it is filled out correctly or it will not be valid.
  3. Give patients at least a 30-day advance notice that they will be required to pay deductibles, coinsurances and/or copays (based on their insurance fee schedule) at the time of service.
  4. Put a notice up in patient rooms and the waiting room that payment of coinsurance, deductible and copay are due at the time of their appointment.
  5. Be sure to add the same statement on to any billing statements that are mailed to patients.
  6. When you remind the patient of their appointment time, remind them also that they will need to be prepared to pay their deductible, coinsurance, or copay at check in and be sure to tell them how much they will be asked to pay so they can be properly prepared.
  7. Be sure the receptionist who checks in the patient collects the amount due either at the time of check in or check out.

Collect Up Front. (2015, March 3). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/collect-up-front-2129.html

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