Billing, Collections Policy & Procedure

POLICY:

After our patients have received services, 佛罗里达大学健康冰球突破平台的政策是准确和及时地为患者和适用的付款人开具账单 manner. During this billing and collections process, staff will provide 优质的客户服务和及时的跟进，以及所有未结清的客户 will be handled in accordance with the IRS and Treasury’s 501(r) final rule under the authority of the Affordable Care Act.

PURPOSE:

It is the goal of this policy to provide clear and consistent guidelines for conducting billing andcollections functions in a manner that promotes compliance, patient satisfaction, and efficiency. Through the use of billing 声明，书面通信和电话，佛罗里达大学健康冰球突破平台 是否会努力告知患者自己的经济责任 and available financial assistance options, as well as follow up with patients regarding outstanding accounts. Additionally, this policy requires 佛罗里达大学健康冰球突破平台作出合理的努力，以确定病人的 有资格获得佛罗里达大学健康冰球突破平台的财政援助 assistance policy before engaging in extraordinary collection actions to obtain payment.

DEFINITIONS:

Extraordinary Collection Actions (ECAs): A list of collection activities, as defined by the IRS and Treasury, that health care organizations may only take against an individual to obtain payment for care after reasonable efforts have been made to determine whether the individual is eligible for financial assistance. These actions 在本政策下文第II节中进一步定义，并包括行动 例如向信用局/报告机构报告不利信息 along with legal/judicial actions such as garnishing wages.
Financial Assistance Policy (FAP): 一个单独的政策，描述UF健康冰球突破平台的财政援助 program—including the criteria patients must meet in order to be 有资格获得经济援助以及由个人办理的手续 may apply for financial assistance.
Reasonable Efforts: A certain set of actions a health care organization must take to determine 个人是否有资格根据UF健康冰球突破平台的财政援助政策获得财政援助. In general, reasonable efforts may include making presumptive determinations of eligibility for full or partial assistance as well as providing individuals with written and oral notifications about the FAP and application processes.

PROCEDURE:

I. Billing Practices

A. Insurance Billing

1. 对于所有有保险的病人，佛罗里达大学健康冰球突破平台将向适用的第三方收费 payers (as based on information provided by or verified by the patient) in a timely manner.
2. If a claim is denied (or is not processed) by a payer due to an error on 我们代表佛罗里达大学健康冰球突破平台不会向患者收取任何费用 in excess of what the patient would have owed had the payer paid the claim.
3. 如果索赔被拒绝(或不处理)由付款人由于外部因素 of our organization’s control, staff will follow up with the payer and patient as appropriate to facilitate resolution of the claim. If resolution 不发生审慎的后续努力，UF健康冰球突破平台可以 给病人开账单或采取其他符合现行规定的措施 and industry standards.

B. Patient Billing

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. 对于参保患者，在第三方支付者处理了索赔后， 佛罗里达大学健康冰球突破平台将为患者及时开出各自的账单 liability amounts as determined by their insurance benefits.
3. 所有的病人都可以在任何时候要求一份详细的账单.
4. 如果病人对他或她的说法有异议并要求提供有关的文件 对账单，工作人员将以书面形式提供所要求的文件 within 10 days (if possible) and will hold the account for at least 30 days before referring the account for collection.
5. 佛罗里达大学健康冰球突破平台可以批准支付计划安排的病人谁 表明他们可能难以在一次分期付款中支付余额.
   1. Patient Financial Services Management has the authority to make exceptions to this policy on a case-by-case basis for special circumstances.
   2. UF健康冰球突破平台不需要接受病人发起的付款安排 and may refer accounts to a collection agency as outlined below if the 病人不愿作出可接受的付款安排或已违约 on an established payment plan.

II. Collections Practices

A. In compliance with relevant state and federal laws, and in accordance with the provisions outlined in this Billing and Collections Policy, 佛罗里达大学健康冰球突破平台可能从事收集活动-包括特别 collection actions (ECAs)—to collect outstanding patient balances.

1. General collection activities may include [follow-up calls on statements]
2. Patient balances may be referred to a third party for collection at the discretion of UF Health Flagler Hospital. Accounts will be referred for collections only with the following caveats:
   1. There is a reasonable basis to believe the patient owes the debt.
   2. All third-party payers have been properly billed, and the remaining debt is the financial responsibility of the patient. UF Health Flagler Hospital shall 不向病人开出保险公司有义务支付的任何金额的账单.
   3. 佛罗里达大学健康冰球突破平台将不转介帐户收集，而索赔 the account is still pending payer payment. However UF Health Flagler Hospital may classify certain claims as “denied” if such claims are stuck in “pending” mode for an unreasonable length of time despite efforts to facilitate resolution.
   4. 佛罗里达大学健康冰球突破平台将不转介帐户收集凡索赔 was denied due to a UF Health Flagler Hospital error. However, UF Health Flagler Hospital 是否仍可将这类申索的病人责任部分转介收取 if unpaid.
   5. 佛罗里达大学健康冰球突破平台将不转介帐户收集哪里的病人 是否已申请经济资助或其他UF健康冰球突破平台 佛罗里达大学健康冰球突破平台尚未通知患者 of its determination (provided the patient has complied with the timeline and information requests delineated during the application process).

B. Reasonable Efforts and Extraordinary Collection Actions (ECAs)

1. 在参与eca以获得护理付款之前，UF健康冰球突破平台必须 make certain reasonable efforts to determine whether an individual is eligible for financial assistance under our financial assistance policy:
   1. ECAs只能在第一次出院后120天开始 statement was provided.
   2. However, at least 30 days before initiating ECAs to obtain payment, UF Health Flagler Hospital shall do the following:
      1. 向个人提供一份书面通知，表明该职位的可用性 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 and 30 days after the written notice)
      2. 提供FAP的简单语言摘要以及上述通知
      3. Attempt to notify the individual orally about the FAP and how he or she may get assistance with the application process
2. 在做出合理的努力后确定经济援助资格 如上所述UF健康冰球突破平台(或其授权的业务合作伙伴) may take the following ECA to obtain payment for care:
   1. 向信用报告机构和/或信用局报告不利信息
3. If a patient has an outstanding balance for previously provided care, UF Health Flagler Hospital may engage in the ECA of deferring, denying, or requiring payment before providing additional medically necessary (but non-emergent) care only when the following steps are taken:
   1. UF健康冰球突破平台为患者提供FAP应用程序和平原 language summary of the FAP
   2. UF健康冰球突破平台提供书面通知，表明可用性 财政援助和指定任何期限后，完成 application for assistance for the previous care episode will no longer be accepted. This deadline must be at least 30 days after the notice date or 240 days after the first post-discharge billing statement for prior care—whichever is later.
   3. 佛罗里达大学健康冰球突破平台作出合理的努力口头通知个人 关于财政援助政策，并说明如何获得援助 with the application process.
   4. UF健康冰球突破平台处理在加速的基础上任何FAP申请 previous care received within the stated deadline
4. Patient Financial Services is ultimately responsible for determining if an individual is eligible for financial assistance. This body also has final authority for deciding whether the organization may proceed with any of the ECAs outlined in this policy.

III. Financial Assistance

所有帐单患者将有机会联系UF健康冰球突破平台 regarding financial assistance for their accounts, payment plan options, and other applicable programs.

1. UF Health Flagler Hospital’s financial assistance policy is available free of charge.

Request a copy:

• In person at any registration location at UF Health Flagler Hospital
• 通过致电账单部/金融倡导者904-819-4539或邮寄 a request 2155 Old Moultrie Rd Suite 103, St. Augustine, FL 32086
• Online at http://www.flaglerhospital.org/
  • 个人对用友健康冰球突破平台的财务问题 assistance policy may contact the financial counseling office by phone at 904-819-4539 or in person at 400 Health Park BLVD, St. Augustine, FL 32086

IV. Customer Service

A. 在计费和收款过程中，UF健康冰球突破平台将提供 quality customer service by implementing the following guidelines:

1. 佛罗里达大学健康冰球突破平台将对虐待，骚扰， offensive, deceptive, or misleading language or conduct by its employees.
2. UF健康冰球突破平台将保持一个简化的过程，为病人的问题 and/or disputes, which includes a toll-free phone number patients may call and a prominent business office address to which they may write. This information will remain listed on all patient bills and collections statements sent.
3. After receiving a communication from a patient (by phone or in writing), UF健康冰球突破平台的工作人员将返回电话给病人及时 尽可能(但不超过接到电话后一个工作日) and will respond to written correspondence within 10 days.
4. 佛罗里达大学健康冰球突破平台将保留患者投诉日志(口头或书面)。 that will be available for audit.