Check for clues that your practice is improperly waiving copayments

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a set of compliance red flags drawn from an Office of Inspector General special fraud alert about copayment waivers. It is aimed at medical practice leaders, billing staff, and compliance personnel who want to evaluate advertising, patient financial policies, hardship documentation, and collection practices for potential risk. The piece focuses on general guidance for recognizing problematic patterns and improving internal policy review.

Why This Topic Matters

Improper waiver practices can create legal and compliance exposure for practices that bill federal health care programs. Understanding the warning signs helps organizations review procedures, train staff, and reduce risk associated with patient cost-sharing policies.

What You Will Learn

  • How to recognize general warning signs associated with copayment waiver practices.
  • Why patient financial policy review matters for compliance.
  • Which operational areas are commonly reviewed when assessing waiver risk.
  • How Office of Inspector General guidance can inform staff training and policy checks.

Who Should Read This

  • Physician practices
  • Billing staff
  • Compliance officers
  • Practice managers
  • Revenue cycle teams

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