APPROVED BY: Governing Body
DATE EFFECTIVE: 05/17/2011
DATE(S) REVISED: 02/19/2013
JOINT COMMISSION STANDARD: LD.04.02.03,
Columbia Ancillary Services, Inc. utilizes a commercial billing software to bill electronically all third party payers that have the capability. The third-party payers include Medicare, Medicaid and most private insurances.
Upon the request of the patient or person legally responsible for the patient, the company will bill the patient’s insurance(s) for any equipment, product or service performed. The patient or legal representative will be informed of their financial obligations including their obligation if the insurance claim is denied. The patient or legal representative will be required to sign a form that they understand their financial obligations.
When the company accepts assignment and bills a third-party payer for equipment, product or service performed, the company will write off the difference between the company charge and the insurance allowable, if any. If the patient has insurance to cover co-pay amounts, the company will bill that insurance for the patient. The company expects payment for any co-pay amounts that are not covered by other third-party payers.
If the company believes the equipment, product or service performed is not covered by the patient’s insurance, the patient will be informed of this and required to sign a waiver that they understand the equipment, product or service performed may not be covered and that if the claim is denied they would be responsible for the payment of services. Issues of hardship will be decided by the Corporate Office.
Billing records are audited on a regular basis to insure correct billing to all third-party payers. Any errors will be corrected within 15 days of any finding of error. On receipt of notification by any third-party payer for a billing error(s), the error will be corrected within 15 days or as instructed by the payer.