开票、收款政策 & 过程

政策:

在我们的病人接受服务后，这是弗拉格勒的政策 Hospital to bill patients and applicable payers accurately and in a timely 的方式. 在此计费和收款过程中，工作人员将提供 quality customer service and timely follow-up, and all outstanding accounts 将按照美国国税局和财政部的501(r) 《玩滚球的十大平台》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 声明，书面通信和电话，玩滚球的十大平台 will make diligent efforts to inform patients of their financial responsibilities 以及可用的财政援助方案，以及跟进 未结清账目的患者. 此外，该政策要求 玩滚球的十大平台做出合理的努力来确定病人的 有资格获得玩滚球的十大平台的财政援助 从事特别催收行动前的援助政策 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 医疗保健机构可能只针对个人获得 在作出合理的努力确定后支付照顾费用 个人是否有资格获得经济援助. 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 以及诸如扣押工资等法律/司法行动.
经济资助政策: A separate policy that describes 玩滚球的十大平台’s financial assistance 项目，包括患者必须满足的标准 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 healthcare organization must take to determine whether 个人有资格获得经济援助 under Flagler 医院的财政援助政策. 总的来说，合理的努力 可能包括推定是否有资格获得全额 或部分协助，以及为个人提供书面和 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, 玩滚球的十大平台 will bill applicable third-party 付款人(根据患者提供的信息或经患者核实的信息) 及时地.
2. If a claim is denied (or is not processed) by a payer due to an error on 我们代表玩滚球的十大平台不会向病人收取任何费用 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 在我们组织的控制下，工作人员会跟进付款人 并尽可能耐心地协助解决索赔问题. 如果分辨率 不发生审慎的后续努力，玩滚球的十大平台可以 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, 玩滚球的十大平台 will bill patients in a timely fashion for their respective 责任金额由其保险收益决定.
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 在10天内(如果可能的话)，并将持有账户至少30天 提款前的天数.
5. 玩滚球的十大平台可以批准病人的付款计划安排 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 在特殊情况下，根据具体情况执行本政策.
   2. 玩滚球的十大平台 is not required to accept patient-initiated payment arrangements 并可将帐户转介给如下所述的催收机构 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. 在遵守相关的州和联邦法律，并按照 with the provisions outlined in this Billing and Collections Policy, Flagler 医院可能会从事收集活动，包括非常规的 收集行动(ECAs) -收集未偿还的患者余额.

1. General collection activities may include [follow-up calls on statements]
2. 患者余额可转介给第三方收集在 玩滚球的十大平台自行决定. 账户将被转到收款处 只有以下注意事项:
   1. 有合理的理由相信病人欠了这笔债.
   2. 所有第三方支付方均已妥为结算，剩余债务也已付清 是病人的经济责任吗. 玩滚球的十大平台 not bill a patient for any amount that an insurance company is obligated to pay.
   3. 玩滚球的十大平台 will not refer accounts for collection while a claim on 该账户仍在等待付款人付款. 但是玩滚球的十大平台可能 如果某些要求被卡住，将其归类为“拒绝” 在"待定"模式中等待不合理的时间，尽管 促进解决的努力.
   4. 玩滚球的十大平台不会将账户转到收取索赔的地方 因为玩滚球的十大平台的失误而被拒绝了. 然而，玩滚球的十大平台 may still refer the patient liability portion of such claims for collection 如果无薪.
   5. 玩滚球的十大平台 will not refer accounts for collection where the patient 是否已申请财政援助或其他玩滚球的十大平台 玩滚球的十大平台还没有通知病人 of its determination (provided the patient has complied with the timeline 以及在申请过程中描述的信息要求).

B. 合理努力和特别催收行动(eca)

1. 在参与eca以获得护理费用之前，玩滚球的十大平台必须 做一些合理的努力来确定一个人是否 有资格根据我们的资助政策申请资助的人士:
   1. ECAs may begin only when 120 days have passed since the first post-discharge 提供声明.
   2. However, at least 30 days before initiating ECAs 获得付款, Flagler 医院应做到以下几点:
      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. 尝试口头告知患者FAP的情况，以及他或她如何 在申请过程中可以得到帮助吗
2. After making reasonable efforts to determine financial assistance eligibility 如上所述玩滚球的十大平台(或其授权的业务合作伙伴) 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, Flagler Hospital may engage in the ECA of deferring, denying, or requiring payment 在提供额外的医疗必要(但非紧急)护理之前 只有在采取以下步骤时:
   1. 玩滚球的十大平台 provides the patient with an FAP application and a plain FAP的语言摘要
   2. 玩滚球的十大平台提供书面通知，说明可用性 of financial assistance and specifying any deadline after which a completed 不再为先前的护理事件申请援助 被接受. 该截止日期必须在通知日期后至少30天 或在第一次出院后240天内对账单进行事先结算 关心——以较晚者为准.
   3. 玩滚球的十大平台 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. 玩滚球的十大平台 processes on an expedited basis any FAP applications for 在规定期限内收到的先前护理
4. 患者金融服务最终负责确定是否 个人有资格获得经济援助. 这个机构也有 决定组织是否可以继续进行的最终权力 本政策中概述的任何eca.

3. 金融援助

All billed patients will have the opportunity to contact 玩滚球的十大平台 regarding financial assistance for their accounts, payment plan options, 以及其他适用程序.

1. 玩滚球的十大平台的财政援助政策是免费的 电荷.

索取副本:

• 亲自到玩滚球的十大平台的任何登记地点
• 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/
  • 有关于玩滚球的十大平台财务问题的人 援助政策可以通过电话联系财务咨询办公室 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, 玩滚球的十大平台 will provide 通过实施以下准则，为客户提供优质服务:

1. 玩滚球的十大平台 will enforce a zero tolerance standard for abusive, harassing, 雇员的冒犯性、欺骗性或误导性的语言或行为.
2. 玩滚球的十大平台 will maintain a streamlined process for patient questions 和/或纠纷，其中包括一个免费电话号码，患者可以 电话和一个显眼的商业办公室地址，他们可以写信给你. 这些信息将继续列在所有病人的账单和收款单上 语句发送.
3. After receiving a communication from a patient (by phone or in writing), 玩滚球的十大平台的工作人员会尽快回复病人的电话 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. 玩滚球的十大平台 will maintain a log of patient complaints (oral or written) 这将供审计使用.