Point of Service Policy
Policy Purpose:
The purpose of this policy is to establish governance and protocols for Colonial Outpatient Surgery Center, to notify patients of their financial responsibility prior to the date of service. Daily verification of insurance eligibility allows centers to provide an estimate of patient’s share of cost.
Persons Affected
This policy is applicable to all teammates, business associates (contractors, consultants, temporaries, volunteers, physicians, clinicians, and other workforce members at SCA), including all personnel affiliated with third parties.
Definitions
DOS (Date of Service)
PAS (Patient Accounting System)
Policy Statement
Prior to the date of service, patients will be contacted via phone or One Medical Passport to notify them of their financial responsibility. The responsibility includes copay, deductible, and coinsurance.
Best practice is to collect 100% of patient estimate/share of cost prior to or on the DOS, and to contact the patient at a minimum of five days prior to the date of service.
In the event that the patient has paid their deductible to the physician’s office prior to the date of service, as a courtesy, Colonial Outpatient Surgery Center may apply the total amount paid towards the patient’s Pre-Service Estimate and Balance Resolution Plan as long as a copy of the physician’s office receipt is provided.
Payment Plans
If the patient or responsible party is unable or unwilling to pay their estimated financial responsibility on or before the DOS, a payment plan option may be available if the criteria below is met:
- Patient has satisfied the deductible amount.
- The patient has applied for CareCredit and received a denial letter.
Payment plans will not be offered for deductibles, copays, or self-pay/cosmetic procedures.
Once a payment plan has been approved, the patient will be required to follow the steps outlined:
- The patient will be able to choose from the installment options below when electing to enroll in a payment plan:
- Identify what the patient can pay prior to admission and payoff period.
- 50% on admission and the balance in 30 days. This payment plan should be quoted first. If the patient cannot meet the requirements of this payment plan, the second option can be given.
- 50% on admission and the balance within 60 days. If the patient cannot meet the requirements of this payment plan, the third option can be given. Requires monthly payments until full balance is paid.
- 33% on admission and the balance within 60 days. If the patient cannot meet the requirements of this payment plan, contact the CEO or Business Office Manager for further options.
- The patient will be required to leave a credit card on file for payments to be withdrawn automatically until the payment plan is satisfied.
- If the patient cannot meet the requirements or agree to the terms set forth, the account will be escalated to the Business Office Manager or Administrator. If at any time the patient defaults on the payment plan, the balance may be sent to collections, and the patient will not be eligible for any future payment plan options at Colonial Outpatient Surgery Center.
Enforcement
These policies, procedures, and forms are compiled based on both legal and regulatory requirements as well as industry standard best practices. People are expected to use established practices and sound judgment in making decisions.
Any teammate found to have violated this policy may be subject to disciplinary action, up to and including termination of employment.
Business associates found to have violated this policy may be subject to financial penalties, up to and including termination of contract.
SCA policies and procedures are confidential proprietary information that should not be disclosed to individuals outside SCA, or to teammates who do not need the information to perform their duties unless expressly authorized by a supervisor or manager. All confidential or proprietary information should be protected against theft, loss, and unauthorized disclosure.
Review and Update:
This policy is to be reviewed annually to determine if the policy complies with current regulations and SCA practices. If significant related changes occur, the policy will be reviewed and updated as needed.