tci Medicare Compliance & Reimbursement - 2011 Issue 5
Billing: Know When You Can Write Off a Patient Balance -- and When to Avoid It
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Article Overview
This article explains general billing compliance considerations for medical practices evaluating when patient balances may be written off and when that approach can create audit or payer-contract risk. It is aimed at billers, coders, practice managers, and compliance staff, and focuses on collection policy, documentation, financial hardship review, and consistency in handling patient accounts.
Why This Topic Matters
Improper write-offs can affect payer compliance, contract obligations, and fraud-and-abuse exposure. The article helps practices assess whether their collection and hardship processes are documented, consistent, and defensible.
Article Sections
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Avoid Potentially Fraudulent Exceptions
Discusses the general risks of bypassing normal collection efforts and the importance of documenting attempts to collect patient balances. It also addresses broader compliance concerns tied to payer contracts and government scrutiny.
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Keep Financial Hardship Proof If You Do Waive Payments
Covers the need to document financial hardship when considering a balance write-off and the kinds of general information practices may request to support a hardship review.
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Be Consistent in Your Collection Processes
Explains the importance of applying a uniform collections policy across patients and keeping office procedures documented and consistent.
What You Will Learn
- How patient balance write-offs can create compliance concerns
- Why documentation of collection efforts matters
- What kinds of hardship documentation may be relevant
- Why consistency in billing and collections policies is important
- How practice policies can affect patient balance treatment
Who Should Read This
- Medical billers
- Coders
- Practice managers
- Compliance staff
- Physician office administrators
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