Valley Presbyterian Hospital is committed to providing financial assistance
to patients who cannot pay for part or all of the care they receive. Consistent
with our mission and values, we embrace the following principles:
- Patients should be treated equally, with dignity, respect and compassion.
- Concern over a hospital bill should never prevent any individual from receiving
emergency health services.
- Patients should be expected to contribute to the cost of their care based
upon their individual ability to pay.
- Hospital financial aid policies and practices will take into account each
individual's ability to contribute to the cost of his or her care,
as well as the hospital's ability to provide care.
- Financial aid policies should be clear, easy-to-understand, and communicated
in a way that is dignified and in languages appropriate to the community
and patients served.
- Financial aid policies should be made available to prospective and current
patients and to the community at large.
Rosenthal Act
Rosenthal Fair Collection Practices Act and Federal Fair Debt Collection
Practices Act:
State and federal law require debt collectors to treat you fairly and prohibit
debt collectors from making false statements or threats of violence, using
obscene or profane language, and making improper communications with third
parties, including your employer. Except under unusual circumstances,
debt collectors may not contact you before 8:00 a.m. or after 9:00 p.m.
In general, a debt collector may not give information about your debt
to another person other than your attorney or spouse. A debt collector
may contact another person to confirm your location or to enforce a judgment.
For more information about debt collection activities, you may contact
the Federal Trade Commission by telephone at 877-FTC-HELP (877-382-4357)
or online at www.ftc.gov.
Patient Financial Services Collection Process Guidelines
Purpose:
To provide guidelines to ensure accounts are followed-up in a timely manner.
Guidelines:
In order to ensure that proper and timely follow-up on accounts is performed
after billing, the procedure below must be followed. Some exceptions can
be made, as risk management may need to hold, adjust or write off an account.
Other exceptions may be granted by the Chief Financial Officer or the
Director of Revenue Cycle. All new staff members are trained on the process below.
Procedure:
A. Managed Care, Commercial, Medicare, Medi-Cal and all payers:
- After claims are submitted to the insurance carriers either electronically
or hard copy, the Patient Financial Services (PFS) staff calls or inquires
on the website of the insurance company to see when the claim will be
paid. If there is a secondary or tertiary payer, the claim is then submitted
to that carrier. Once the insurance company has issued payment, and the
account has been reviewed by the claims adjuster, the balance remaining
is due by the patient.
- If a denial is received, the account is resubmitted or appealed based on
the type of denial. If the claim continues to be denied by the insurance
carrier for reasons such as no medical necessity or no authorization,
the claim may need to be written off.
- Ten days after the payment is received, and there is a patient balance
owing, the account is reffered to Healthcare Resource Group (HRMG) which
is used as an extension of the Business Office. HRMG sends out a series
of letters to patients, requesting payment on his/her account. The account
remains with HRMG for 120 days while they pursue the patient. If no payment
or payment arrangement is made in that time, the account is then referered
to an outside Collection Agency.
B. Self-Pay accounts:
- Self-pay accounts are referred to HRMG three days after the claims become
Final Bill status. HRMG sends out a series of letters to patients, requesting
payment on his/her account. The account remains with HRMG for 120 days
while they pursue the patient. If no payment or payment arrangement is
made in that time, the account is then referred to an outside Collection
Agency. If insurance is found after an account has been referred to an
outside Collection Agency, the agency either bills and follows up on the
account, or returns it to the hospital for billing and follow up, depending
on the insurance.
C. The outside Collection Agency assigments are determined by an alpha
split that changes yearly. The Collection Agency abides by all hospital policies.
Please contact our Patient Financial Services Department at 818.902.2913
for more details.