Generalized & Boutique Debt Collection Services
Substance abuse debt collections is a critical area for many organizations in behavioral health. In general, treatment centers, detox's, physician groups and other types of medical and behavioral providers are placed in a legal position of having to follow up and make attempts to collect debt from their clients. Co-pays, deductibles and other types of debt resulting from legal and appropriate advancements of funds to such clients.
The addiction treatment, medical and behavioral health provider are required to make good faith efforts to collect debt owed by a client. Some of the types of debt which might fall into such categories would be co-pays, deductibles and loan of funds for airline tickets, residential expenses, personal expenses and more. Advancements of funds are appropriated under a defined set of circumstances and cannot amount to what might be defined as an inducement to influence the client to attend that particular center. Many providers make costly mistakes in this area.
Understanding Debt Collection Promissory Notes
In the case of advancements and loans to clients for airline tickets, the client should be providing to the drug and alcohol treatment center or detox facility an executed promissory note. It should include a payback schedule, itemized financial statement reflecting liabilities, income and expenses. These should reflect the clients need as well as a request from the client for such advancement. In addition, a statement from the client that they are unable to pay for the particular item of expense for which they are requesting the advancement.
Under no circumstances is it legally appropriate for a substance abuse treatment provider to simply provide funding to a client, or a potential client, merely to influence the client to attend that provider’s treatment program. There is no legally appropriate concept at work in which provider would be placed in a position of “out-bidding” each other for a particular client admission. We are always available to answer any questions about your collection procedures.
Substance Abuse Collections and the Law
Pay 2 Patient, LLC can and does selectively act as a collection agent to follow such debt and in adherence to the Fair Debt Collection Practices Act (FDCPA.) This Federal Law, found at 15 USC Section 1692, follows appropriate guidelines to communicate with and collect such debt from the providers debtor. It includes the amount of co-pays and deductibles owed by the client. In addition, other types of debts owed to the provider by the client such as appropriate and legal loans.
The founders of Pay 2 Patient, LLC have many years of experience in substance collections, and will take all legally appropriate actions to follow, communicate with and to obtain repayment of the debt owed to the provider. This is accomplished by a wide variety of proven collections procedures. This also includes the rare cases of legal action although such is rarely recommended as an initial step. The fee charged by Pay 2 Patient, LLC is based up the length of time that the debt has been outstanding and on a percentage basis of collected fees.
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Substance Abuse Collections Costly Mistakes
Behavioral health collections is complicated with many dollars being lost. Addiction treatment centers and private physicians are unaware when providers make payment for services directly to an individual. This happens often with out of network providers. Usually treatment providers find out too late about the circumstances of this payment situation between the providers and an individual.
What are the pitfalls to be aware of if you are a behavioral health provider?
Out of Network (OON) claims are usually more costly to the insurance carrier and to the patient. As a mechanism to encourage participation in its' network (and because certain laws mandating this to happen) carriers will issue payment directly to the provider on behalf of the patient. However, some carriers do not extend this outcome to non-participating or OON providers. Some carriers (Empire and Federal BCBS in Florida) issue payment directly to the patient. The reimbursement check is made payable to the patient not to the service provider. This can disrupt the provider’s cash flow and this creates the Pay 2 Patient circumstance. This usually occurs when the insured does not execute the assignment of benefits and attest to it.
Assisting with Your Behavioral Health Collections
Providers become understandably confused about how this could happen considering that the providers billing and admissions staff had the patient execute all the correct authorizations, and a verified assignment of benefit (AOB) at the time of admission. Most providers think that if all such documentation is executed by the patient that regardless of whether they are in network or out of network the insurance reimbursement checks will be sent to their office. For many providers the assignment from the patient is unlikely to be honored by the carrier and its check will be sent to the patient anyway. This comes as a surprise to many providers who expect to receive the check from the carrier so long as it has a valid attested assignment of benefits.
In many cases both the patient and the provider’s staff are unaware that the insurance checks will be sent directly to the patient, even when the patient had already given the provider an assignment of benefits. And, even when the staff has informed the carrier of mistakes and oversights that are often made. Sometimes, it is only during a routine claim A/R review that the billing staff realizes that the check they have been waiting for has already been sent to the patient. The carrier generally does not routinely inform the providers billing staff of this circumstance.
This is when the problem becomes acute and financially damages the providers anticipated cash flow because it is extremely difficult for the provider to recover such insurance payments from the patient who has already received the check and potentially has cashed it. Obviously, the practice of issuing checks directly to patients instead of to the provider has greatly impacted the cash flow of many providers. Providers in Florida should make sure that the insured also executes an AOB and attests to it.