E/M Coding Alert - 2005 Issue 37
Rehab: Collect Copays, Or OIG Could Come Knocking
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Article Overview
This article explains how rehabilitation practices can structure copayment and waiver policies in a way that supports compliance with payer and government scrutiny. It is aimed at providers, practice managers, and compliance staff who need general guidance on collection procedures, written policies, financial-need verification, auditing, and employee communication around patient billing concerns.
Why This Topic Matters
Copayment and waiver practices can draw attention from government oversight and private payers when they appear too permissive or inconsistently applied. The article helps readers understand the compliance risks and operational safeguards associated with patient collection policies.
What You Will Learn
- Why copayment collection practices are a compliance concern for rehab providers
- The importance of having a written policy for waiver and discount decisions
- Ways providers may document or verify financial need information
- Why periodic review of waiver decisions is emphasized
- How staff communication during intake can affect compliance risk
Who Should Read This
- Rehabilitation providers
- Practice managers
- Healthcare compliance staff
- Billing and collections personnel
- Healthcare attorneys
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