Patient Inability to Pay: Managing the Risks
December 7, 2022
Dear OMIC Insureds:
Ophthalmologists sometimes encounter situations in which a patient cannot pay their deductible, coinsurance, and/or co-pays. This creates a range of risk management concerns, from handling a patient who declines care because of an inability to pay, to deciding whether terminating the relationship with the patient is appropriate. OMIC’s risk management resource, Termination of Care for Financial Reasons, provides guidance on how to evaluate reasons for non-payment, steps needed to terminate the relationship if deemed necessary, and sample letters to support communication and documentation of the process.
This resource also emphasizes the importance of communicating financial obligations to patients at the outset of treatment. For example:
- Notify new patients that it is their responsibility to pay for care.
- Explain that if they have insurance of any kind, including from the federal or state government, you are obligated by law and contracts to collect any deductible or co-payment at the time of service.
- Ask patients to speak to your billing manager if they need assistance in coordinating payment from an insurance company or making a payment plan or have difficulty making their co-payment or deductible.
If you have questions, contact us for confidential risk management advice at riskmanagement@omic.com or 1-800-562-6642, enter 4 for OMIC Risk Management.
Sincerely,
Jane Mock, CPHRM
OMIC Risk Manager
