Policies and Procedures
The following are examples of areas that should be addressed in Business Office Policies and Procedures. A much more detailed version is available by contacting John Shell.
General Policies:
- Admission Financial Policy
- Emergency Care and Treatment Policy
- Payment Policy - Emergency Department Services
- Hospital Credit Policy
- Signs and Handout Notification Policy
- Forms of Obligation
Admission Financial Policy:
- The hospital has a moral responsibility to the community to render care to all persons, including those unable to pay.
- The purpose of such a policy is to give hospital personnel the necessary guidelines for classifying patients according to their resources and ability to pay and for collecting as much as possible from those who are able to pay.
- Verification of insurance benefits is a necessity in order to determine the portion of patient pay that will be involved.
- This policy would include the screening methods to be used to qualify persons unable to pay for indigent care or other charity programs.
Emergency Care And Treatment Policy:
- Number one priority is to be in compliance with the Texas State Emergency Services Act of 1983.
- If the hospital normally provides emergency service and has a physician available, then service must be provided regardless of the patient's ability to pay.
- Emergency is defined as any situation that threatens the patient’s loss of life or limb, loss of use of limb or organ, or an obstetrical patient in active labor.
Payment Policy – Emergency Department Services:
- This policy should describe the hospital’s effort to collect payment at time of service for services rendered.
- Triage would be necessary to help determine the proper time to make payment requirements know to the patient.
- Estimates of insurance coverage would have to be made on the spot in order to be able to attempt collections of patient pay portions.
- Patients in non-emergency situations who are apparently able but unwilling to make payment or financial arrangements could be considered for denial of services.
Hospital Credit Policy:
- Hospitals are not credit or lending institutions. However, a policy must exist to give direction and authority to the staff in handling patients who require payment plans in order to meet their obligation.
- In order to establish an acceptable and realistic payment amount for each patient, a detailed application must be made referencing income and financial obligations.
- Installment arrangements should be reduced to a promise to pay document signed by the patient and witnessed by a hospital employee.
Signs And Handout Notification Policy:
- Establishing a payment requirement policy is just one part of effective “cash at time of service” recovery success.
- The public must be educated.
- Signs must be conspicuously located at all registration and admission points, and at all cashier stations.
- In addition to signs, handouts should be included whenever possible.
Example of such signs:
- Patients with insurance need to show proof of insurance.
- Charges above insurance coverage are due at time of service.
- Patients without insurance coverage are expected to pay all charges at time of service.
Forms Of Obligation Policy:
The policy of the hospital should be to secure all forms that will identify and obligate the patient and to ensure that the hospital is protected and will be paid for all services.- Authorization For Treatment
- Assignment Of Benefits
- Payment Agreement
- Promissory Note
- Hospital Lien
- Advance Directive