开票、收款政策 & 过程

政策:

在我们的病人接受服务之后, it is the policy of 佛罗里达大学健康冰球突破平台 to bill patients and applicable payers accurately and in a timely 的方式. During this billing and collections process, staff will provide quality customer service and timely follow-up, and all outstanding accounts will be handled in accordance with the IRS and Treasury’s 501(r) 《冰球突破平台》授权下的最终裁决.

目的:

It is the goal of this policy to provide clear and consistent guidelines for conducting billing andcollections functions in a 的方式 that promotes 依从性、患者满意度和效率. 通过使用计费 statements, written correspondence, and phone calls, 佛罗里达大学健康冰球突破平台 will make diligent efforts to inform patients of their financial responsibilities and available financial assistance options, as well as follow up with 未结清账目的患者. 此外，该政策要求 佛罗里达大学健康冰球突破平台 to make reasonable efforts to determine a patient’s eligibility for financial assistance under 佛罗里达大学健康冰球突破平台’s financial assistance policy before engaging in extraordinary collection actions 获得付款.

定义:

特别催收行动(eca): A list of collection activities, as defined by the IRS and Treasury, that health care organizations may only take against an individual to obtain payment for care after reasonable efforts have been made to determine whether the individual is eligible for financial assistance. 这些行动 are further defined in Section II of this policy below and include actions such as reporting adverse information to credit bureaus/reporting agencies along with legal/judicial actions such as garnishing wages.
经济资助政策: A separate policy that describes 佛罗里达大学健康冰球突破平台’s financial assistance program—including the criteria patients must meet in order to be eligible for financial assistance as well as the process by which individuals 可以申请经济资助吗.
合理的努力: A certain set of actions a health care organization must take to determine whether 个人有资格获得经济援助 under 佛罗里达大学健康冰球突破平台’s financial assistance policy. 总的来说，合理的努力 may include making presumptive determinations of eligibility for full or partial assistance as well as providing individuals with written and 口头通报FAP计划及申请程序.

过程:

I. 计费实践

A. 保险账单

1. For all insured patients, 佛罗里达大学健康冰球突破平台 will bill applicable third-party payers (as based on information provided by or verified by the patient) 及时地.
2. If a claim is denied (or is not processed) by a payer due to an error on our behalf, 佛罗里达大学健康冰球突破平台 will not bill the patient for any amount in excess of what the patient would have owed had the payer paid the claim.
3. If a claim is denied (or is not processed) by a payer due to factors outside of our organization’s control, staff will follow up with the payer and patient as appropriate to facilitate resolution of the claim. 如果分辨率 does not occur after prudent follow- up efforts, 佛罗里达大学健康冰球突破平台 may bill the patient or take other actions consistent with current regulations 以及行业标准.

B. 病人计费

1. All uninsured patients will be billed directly and timely, and they will receive a statement as part of the organization’s normal billing process.
2. For insured patients, after claims have been processed by third-party payers, 佛罗里达大学健康冰球突破平台 will bill patients in a timely fashion for their respective liability amounts as determined by their insurance benefits.
3. All patients may request an itemized statement for their accounts at any time.
4. If a patient disputes his or her account and requests documentation regarding the bill, staff members will provide the requested documentation in writing within 10 days (if possible) and will hold the account for at least 30 提款前的天数.
5. 佛罗里达大学健康冰球突破平台 may approve payment plan arrangements for patients who indicate they may have difficulty paying their balance in a single installment.
   1. 病人 金融服务 Management has the authority to make exceptions to this policy on a case-by-case basis for special circumstances.
   2. 佛罗里达大学健康冰球突破平台 is not required to accept patient-initiated payment arrangements and may refer accounts to a collection agency as outlined below if the patient is unwilling to make acceptable payment arrangements or has defaulted 在一个既定的付款计划.

II. 集合行为

A. In compliance with relevant state and federal laws, and in accordance with the provisions outlined in this Billing and Collections Policy, 佛罗里达大学健康冰球突破平台 may engage in collection activities—including extraordinary collection actions (ECAs)—to collect outstanding patient balances.

1. General collection activities may include [follow-up calls on statements]
2. 病人 balances may be referred to a third party for collection at the 佛罗里达大学健康冰球突破平台自行决定. 账户将被转到收款处 只有以下注意事项:
   1. There is a reasonable basis to believe the patient owes the debt.
   2. All third-party payers have been properly billed, and the remaining debt 是病人的经济责任吗. 佛罗里达大学健康冰球突破平台 not bill a patient for any amount that an insurance company is obligated to pay.
   3. 佛罗里达大学健康冰球突破平台 will not refer accounts for collection while a claim on 该账户仍在等待付款人付款. 然而佛罗里达大学健康冰球突破平台可能 classify certain claims as “denied” if such claims are stuck in “pending” mode for an unreasonable length of time despite 促进解决的努力.
   4. 佛罗里达大学健康冰球突破平台 will not refer accounts for collection where the claim 因为佛罗里达大学健康冰球突破平台的失误而被拒绝了吗. 然而，佛罗里达大学健康冰球突破平台 may still refer the patient liability portion of such claims for collection 如果无薪.
   5. 佛罗里达大学健康冰球突破平台 will not refer accounts for collection where the patient has initially applied for financial assistance or other 佛罗里达大学健康冰球突破平台 sponsored program and 佛罗里达大学健康冰球突破平台 has not yet notified the patient of its determination (provided the patient has complied with the timeline and information requests delineated during the application process).

B. Reasonable Efforts and Extraordinary Collection Actions (ECAs)

1. Before engaging in ECAs 获得付款 for care 佛罗里达大学健康冰球突破平台 must make certain reasonable efforts to determine whether an individual is eligible for financial assistance under our financial assistance policy:
   1. ECAs may begin only when 120 days have passed since the first post-discharge 提供声明.
   2. 然而, 在启动eca以获取付款前至少30天, 佛罗里达大学健康冰球突破平台将做以下工作:
      1. Provide the individual with a written notice that indicates the availability of financial assistance, lists potential ECAs that may be taken to obtain payment for care, and gives a deadline after which ECAs may be initiated (no sooner than 120 days after the first post-discharge billing statement (书面通知后30天内)
      2. Provide a plain-FAP的语言摘要 along with the notice described above
      3. Attempt to notify the individual orally about the FAP and how he or she 在申请过程中可以得到帮助吗
2. After making reasonable efforts to determine financial assistance eligibility as outlined above 佛罗里达大学健康冰球突破平台 (or its authorized business partners) 可采取以下ECA方式取得医疗费:
   1. Report adverse information to credit reporting agencies and/or credit bureaus
3. If a patient has an outstanding balance for previously provided care, 佛罗里达大学健康冰球突破平台 may engage in the ECA of deferring, 否认, 或者要求付款 before providing additional medically necessary (but non-emergent) care 只有在采取以下步骤时:
   1. 佛罗里达大学健康冰球突破平台 provides the patient with an FAP application and a plain FAP的语言摘要
   2. 佛罗里达大学健康冰球突破平台 provides a written notice indicating the availability of financial assistance and specifying any deadline after which a completed application for assistance for the previous care episode will no longer 被接受. This deadline must be at least 30 days after the notice date or 240 days after the first post-discharge billing statement for prior 关心——以较晚者为准.
   3. 佛罗里达大学健康冰球突破平台 makes a reasonable effort to orally notify the individual about the financial assistance policy and explain how to receive assistance 在申请过程中.
   4. 佛罗里达大学健康冰球突破平台 processes on an expedited basis any FAP applications for 在规定期限内收到的先前护理
4. 病人 金融服务 is ultimately responsible for determining if 个人有资格获得经济援助. 这个机构也有 final authority for deciding whether the organization may proceed with 本政策中概述的任何eca.

3. 金融援助

All billed patients will have the opportunity to contact 佛罗里达大学健康冰球突破平台 regarding financial assistance for their accounts, payment plan options, 以及其他适用程序.

1. 佛罗里达大学健康冰球突破平台’s financial assistance policy is available free 电荷.

索取副本:

• In person at any registration location at 佛罗里达大学健康冰球突破平台
• By calling the Billing Department/Financial Advocate 904-819-4539 or mailing 2155 Old Moultrie Rd Suite 103, St. 奥古斯丁，佛罗里达州32086
• 在网上 http://www.flaglerhospital.org/
  • Individuals with questions regarding 佛罗里达大学健康冰球突破平台’s financial assistance policy may contact the financial counseling office by phone 电话:904-819-4539或亲自到400健康公园BLVD, St. 奥古斯丁，佛罗里达州32086

IV. 客户服务

A. During the billing and collection process, 佛罗里达大学健康冰球突破平台 will provide quality customer service by implementing the following guidelines:

1. 佛罗里达大学健康冰球突破平台 will enforce a zero tolerance standard for abusive, harassing, offensive, deceptive, or misleading language or conduct by its employees.
2. 佛罗里达大学健康冰球突破平台 will maintain a streamlined process for patient questions and/or disputes, which includes a toll-free phone number patients may call and a prominent business office address to which they may write. This information will remain listed on all patient bills and collections 语句发送.
3. After receiving a communication from a patient (by phone or in writing), 佛罗里达大学健康冰球突破平台 staff will return phone calls to patients as promptly as possible (but no more than one business day after the call was received) 并将在10天内回复书面信函.
4. 佛罗里达大学健康冰球突破平台 will maintain a log of patient complaints (oral or written) 这将供审计使用.