Collection Of Payments Policies And Procedures In Healthcare

Payment Procedures and Policy in Health Care
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Payment Policies and Procedures in Health Care
In the U.S, the amount spent in the health care department is way greater when compared to other nations all over the globe. As per the estimates of officials of the US, $2.9 trillion were spent on health care in the year 2014 which was greater than 17% of the economy of the US. Policy makers and researchers of the health system should recognize the factors responsible to increase cost expenditure on health care (Dieleman et al., 2016). There is also a need to develop, design and maintain such payment procedures and policies that make it easy for the public to access health care facilities any time in need.
Payment Plan
Before designing a payment plan, it is essential to understand the terms usually associated with health care. Table 1 adopted from Arora, Moriates & Shah (2015), clearly illustrates how the terms “cost”, “price” and “reimbursement” vary from each other.
Table 1: Definitions of Cost, Price, and Reimbursement (Arora, Moriates & Shah, 2015)
According to Ketchum (2019), it is not possible for the hospitals to be working if they are not paid by the patients. But, it is also a fact that it is beyond the capability of some patients to pay for their health care services. As compared to the insured patients, patients on self-pay are at more risk of being troublesome, when it comes to paying for their health care. A minimum amount can be set which is to be paid by uninsured patients before they are given a service. And this minimum amount can vary depending upon the service the patients may want to acquire from a health care setting. They will be given a voucher/ Medical bill according to which they will be charged as per the type of service, they want to avail. After paying, uninsured patients will get a receipt entailing the patient’s name, his/ her unique identification number, type of service, the advance amount paid, balance amount, contact number and the date of service to be availed. This will be accompanied with the other mandatory details such as the Hospital Name, Department or Facility and signature and stamp of receiving advance amount.
For new patients who are insured, a standard information package will be given by the facility in which a form will be there entailing signed acknowledgment for the financial responsibility along with the agreement from the patient to pay at service time. It will also be verified right away for the validity of patient’s membership. It will also be ensured about precertification issues and covered medical procedures. Precertification is required from the insurance company if they agree to cover the medical procedure prior to the service.
Collection
It has been adopted by many health care facilities that they ask for the credit card number from the patient. As soon as the payment is received from insurance and the exact balance due on patient becomes clear, the soon as the credit card of the patient is charged. After this, a courtesy call is given to the patient, asking from him the remaining amount to be paid at the time of receiving of a service. That is how collec...