RENOWN HEALTH NETWORK
POLICY
Title:
Category:
Number:
Author:
Billing and Collections Policy for
Self Pay
Self Pay Call Center
Page 1 of 5
Current Version
Effective Date:
Next Review Date:
Revision Date:
Revision History:
RENOWN.SPCC Need Number
Mary Fernandez, Director Self Pay Services
Scope: Renown Health and its affiliated companies (Health Network).
Purpose: To establish a standard for the Billing and Collections for Self Pay Accounts
Policy: To set forth the actions that Renown Health Network will take in the event of non–payment of
patient services that are the responsibility of the individual patients and not covered by insurance or
other third-party payment source.
To ensure that reasonable efforts are made to determine whether the individual responsible for payment
of all or a portion of a patient account is eligible for assistance through a Government Program or
under the Financial Assistance Program prior to the commencement of extraordinary collection actions
to collect the account.
This policy covers billing and collections for self-pay accounts both uninsured patients and patients
with insurance. This policy does not cover actions to be taken to enforce any statutory lien that may
exist with respects to the proceeds of any third party recovery to which the patient maybe entitled.
Definition of Terms:
1.
Application Period means the period during which Renown must accept and process an
application for financial assistance under the FAP. The application Period begins on the
date the care is provided and ends on the 245th day after Renown provides the first billing
statement.
2.
Billing Deadline means the date after which Renown may initiate an ECA against the
Responsible Individual who has failed to submit an application for financial assistance
under the FAP, The Billing Deadline must be specific in a written notice to the
Responsible Individual provided at least 30 days prior to such deadline, but no earlier
than the last day of Notification Period.
3.
Completion Deadline means the date after which Renown may initiate or resume an ECA
against an individual who has submitted an incomplete FAP if that individual has not
provided the missing information and/or documentation necessary to complete the
application. The Completion Deadline must be specific in a written notice and must be no
earlier than 30 days after Renown provides the individual with the notice; or the last day
of the Application Period.
RENOWN HEALTH NETWORK
POLICY
Title:
Category:
Number:
Author:
Billing and Collections Policy for
Self Pay
Self Pay Call Center
Page 2 of 5
Current Version
Effective Date:
Next Review Date:
Revision Date:
Revision History:
RENOWN.SPCC Need Number
Mary Fernandez, Director Self Pay Services
4.
Extraordinary Collection Action (EAC) means any action against an individual related to
obtaining payment of a Self-Pay Account that requires legal or judicial process or
involves selling of Self-Pay Account to another party or reporting adverse information
about the Responsible Individual to consumer credit reporting agencies or credit bureaus.
ECAs do not include an action to perfect the statutory lien on claims of liability or
indemnity granted to health care providers under A.R.S. 33-931 or transfer of a Self-Pay
Account to another party for purposes of collection without the use of ECAs.
5.
FAP-Eligible Individual means a Responsible Individual eligible for financial assistance
under the FAP without regard to whether the individual has applied for assistance.
6.
Financial Assistance Policy (FAP) means Renown’s Financial Assistance Program for
uninsured patients and underinsured patients, which includes eligibility criteria, the basis
for calculating FAP, the method for applying, and approval.
7.
Responsible Individual(s) means the patient and any other individual(s) responsibility for
Self-Pay Account. There may be more than one Responsible Individual(s).
8.
Self-Pay Account means that portion of a patients account that is the individual(s)
responsibility of the patient or other Responsible individual(s), net of the application of
payments made by any available healthcare insurance or other third party payer
(including co-payments, co-insurance and deductibles), and net of any reduction or write
off made with respect to such patient account after application of an Assistance Program,
as applicable.
Procedure:
1. Subject to compliance with the provisions of this policy, Renown may take any and all
legal actions, including Extraordinary Collection Actions, to obtain for medical services
provided.
2. Renown will not engage in ECA’s, either directly or by any debt collection agency or
other third party to which the Renown has referred the patient’s debt, before reasonable
efforts are made to determine whether a Responsible Individual(s) is eligible under FAP.
RENOWN HEALTH NETWORK
POLICY
Title:
Category:
Number:
Author:
Billing and Collections Policy for
Self Pay
Self Pay Call Center
Page 3 of 5
Current Version
Effective Date:
Next Review Date:
Revision Date:
Revision History:
RENOWN.SPCC Need Number
Mary Fernandez, Director Self Pay Services
3. All patients will be offered a Plain Language Summary and application form for financial
assistance under FAP as part of the intake process from the hospital.
4. At least four separate statements for collection of the Self-Pay Account shall be mailed
or emailed to the last known address of each Responsible Individual; provided, however,
that no additional statements need to be sent after a Responsible Individual submits a
complete application for financial assistance under the FAP. At least 120 days shall
have elapsed between the first and the required four mailings. It is the Responsible
Individual obligation to provide a correct mailing address at the time of service or upon
moving. If an account does not have a valid address, the determination for “Reasonable
Effort” will have been made.
5. All patients will be given the FAP and application during the admission process.
6. Detail itemizations are mailed out within 7 days of discharge
7. If the Responsible Individual has paid on account the have applied for FAP if determined
eligible for FAB any over payment must be refunded or transferred to any outside
balance not related to the FAP.
8. On the fourth Patient Account statement the patient will receive final notice that informs
the Responsible Parties about the ECAs / further collection activity may be taken, If the
Responsible Individual does make appropriate payment arrangements or apply for
financial assistance program (FAP).
9. ECAs may be commenced as follows:
a) If the Responsible Individual fails to apply for financial assistance.
b) If the Responsible Individual apply for FAP, and Patient Financial Assistance
determines they are ineligible for any assistance under the FAP.
c) If the Responsible Individual submits an incomplete application for financial
assistance and is non cooperative in providing information by the FAP due date.
d) Patients who are able, but unwilling to pay for service are considered
uncollectible bad debts and will be referred to outside agencies for collections.
RENOWN HEALTH NETWORK
POLICY
Title:
Category:
Number:
Author:
Billing and Collections Policy for
Self Pay
Self Pay Call Center
RENOWN.SPCC Need Number
Mary Fernandez, Director Self Pay Services
Page 4 of 5
Current Version
Effective Date:
Next Review Date:
Revision Date:
Revision History:
RENOWN HEALTH NETWORK
POLICY
Title:
Category:
Number:
Author:
Billing and Collections Policy for
Self Pay
Self Pay Call Center
RENOWN.SPCC Need Number
Mary Fernandez, Director Self Pay Services
Page 5 of 5
Current Version
Effective Date:
Next Review Date:
Revision Date:
Revision History: