PI Case Clarification

I was pleasantly surprised last week when I had a patient sign an addendum to our PI Policy without complaining.  Although she had previously signed the more generic policy stating that, if she became responsible for her bill (if it wasn’t paid by an insurance company directly like it should be) she would have to pay the bill, it wasn’t specific enough.  I like to go into more depth about how the patient will most likely be paid directly (it seemed inevitable in this particular case) and if so, she will be required to pay our office within 5 days of receiving the check.  It also states that she understands that if she defaults on her bill, she will incur a penalty of 1.5%/month on the outstanding balance.

I further explain that the charges incurred will be used in determining her settlement amount and so our full charges go out on the final bill.  If and when our bill is reduced, as is typical after running it through pricing software, we will accept that reduced amount only.  The patient may not receive the FULL amount of our bill and then try and negotiate it down with us after the fact.    I also let them know how the process works; you come in for treatment, once you are better or have reached maximum medical improvement, you will be “released from care.”  It is at THIS point that we will submit the bill to the insurance company who then asks the patient if they are done treating with all providers, if so, they begin compiling the settlement proposal.  Lastly I reiterate that I expect full communication, updates, etc. during the settlement process.  I like to put all of this in writing so the patient fully understands how their case will be handled.  Usually, this sparks a great Q & A session where, like this patient I was speaking about, felt completely relieved and informed after discussing the process.  I feel better knowing that she’s been fully informed and that she signed my addendum more specific to her own case.

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