The patient should first identify his or her primary care provider and ensure that the name or phone number of the primary care provider appears on the card. This will validate the transfer of financial responsibility from the patient to the insurance company. If the patient’s card does not bear our name as the primary care provider, financial responsibility for the particular visit shall be transferred to the patient. In this case, the patient will be required to fully pay for the services at the time of service or the time reviewed depending on the patient’s ability to pay. For instance, patients who prove to be undergoing financial hardships can be allowed enough time to make payment. Their payment shall be accepted if it is in the form of liquid cash or personal cheques. However, major credit cards are currently accepted as reliable means of settling medical bills. As for patients with valid insurance covers, they policy requires that they provide co-payments before services are rendered to them. The extent of responsibility the patient may bear regarding co-payments, coinsurances, as well as deductibles, depends on the patient’s insurance plan (Lucas, 2008).
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The part of the medical bill that the patient’s insurance company does not commit to pay shall squarely fall to the patient’s shoulders to pay. This happens quite often and should, therefore, be given special consideration as it can have serious implications on the patient’s pursuit of quality healthcare. In this regard, the medical billing office undertakes to wait for 45 days for the insurance company to make the necessary payments. When this period elapses before the insurance company settles the medical bill, then the care provider will get the go ahead to bill the patient. In addition, there are situations where the insurance company only pays part of the bill and leaves the rest to be cleared by the patient. In such a case, the service provider will bill the patient starting the 15th day since the services were rendered. This basically allows the patient to arrange on how the payment will be made (Hyder, 2007).
Late payments are strictly penalized, especially when there is sufficient evidence that the patient was in a position to clear the bill. The penalty is instituted 10 days after the grace period has elapsed. This implies that the policy gives patients enough time to organize themselves and ensure that patients do not strain in making their payments. Penalties are also instituted for missed or cancelled appointments considering the financial loss the care provider undergoes when a patient does not show up for a booked appointment. In some instances, patients may be denied future appointments if they become frequent victims of missed appointments. This is particularly undertaken to discourage patients from booking appointments when they don’t intend to show up because the financial implications are always grave. For instance, the patient technically locks out willing patients from equally booking appointments and getting medical services (Glied, 2008).
In conclusion, medical financial policy should be availed to patients in the right time to ensure efficient flow of information. They should also accept and show it in writing that they will abide by the provisions of the policy. On the other hand, the care provider should also hire a lawyer to review its policy in order to seal any legal loopholes.
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