Medicare Compliance & Reimbursement - 2011 Issue 8
Billing: Know When You Can Write Off a Patient Balance --And When You Should Avoid It
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Article Overview
This article discusses billing and compliance issues surrounding patient balance write-offs, with emphasis on collection procedures, hardship-based exceptions, payer contract concerns, and the need for consistent office policy. It is aimed at billing staff, coders, compliance personnel, and practice managers who handle accounts receivable and patient financial responsibility. The piece frames the topic as a risk-management and policy issue rather than a coding update.
Why This Topic Matters
Patient balance write-offs can create payer, audit, and fraud-and-abuse exposure if handled inconsistently or without documentation. Understanding the general compliance boundaries helps practices reduce risk while applying collection policies fairly.
Article Sections
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Billing dilemma and compliance risk
Introduces a case study about patient balances and outlines the general compliance concerns raised by routine or selective write-offs.
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Avoid Potentially Fraudulent Exceptions
Discusses collection effort expectations, payer contract concerns, and the risks associated with misleading patients about billing statements.
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Keep Financial Hardship Proof If You Do Waive Payments
Covers hardship-based balance waivers and the need for documentation supporting a patient’s inability to pay.
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Be Consistent in Your Collection Processes
Addresses the importance of applying a uniform collection policy and documenting exceptions within office procedures.
What You Will Learn
- How patient balance write-offs can create compliance concerns
- Why documentation of collection efforts matters
- What general types of information may be used to support financial hardship
- Why consistent collection policies are important across patients
- How payer participation status can affect patient billing practices
Who Should Read This
- Medical billers
- Coders
- Practice managers
- Compliance staff
- Physician office administrators
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