Physicians and patients have found that new regulations around co-pays and coinsurance only worsen the confusion about whether a payment is due, according to an American Medical News report.
The Patient Protection and Affordable Care Act requires in most cases that preventive care be covered without co-pays or coinsurance for patients with private insurance, starting on Sept. 23, 2010. Preventive care includes services such as mammograms, childhood vaccines and tobacco cessation counseling, according to the report.
However, in many cases, neither the physician nor the patient understands the new regulations, and physician practices must spend time contacting payors to determine when they should collect co-pays. In some cases, physician practices mistakenly collect money and must then refund it once they realize the service was covered.
Experts believe physician practices should invest time in understanding the new co-pay regulations, as collecting the correct co-pay at the right time will save time and money involved in chasing the patient down and collecting or refunding the money later.
According to the American Medical News report, the co-pay rules allow for exceptions, letting insurers charge a co-pay when a patient is enrolled in a "grandfathered" health plan that is not subject to health reform's mandates. The exceptions also apply if the physician is out-of-network for the patient plan or if services for another problem are provided during the same visit.
Read the American Medical News report for more details on the co-pay regulations.
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The Patient Protection and Affordable Care Act requires in most cases that preventive care be covered without co-pays or coinsurance for patients with private insurance, starting on Sept. 23, 2010. Preventive care includes services such as mammograms, childhood vaccines and tobacco cessation counseling, according to the report.
However, in many cases, neither the physician nor the patient understands the new regulations, and physician practices must spend time contacting payors to determine when they should collect co-pays. In some cases, physician practices mistakenly collect money and must then refund it once they realize the service was covered.
Experts believe physician practices should invest time in understanding the new co-pay regulations, as collecting the correct co-pay at the right time will save time and money involved in chasing the patient down and collecting or refunding the money later.
According to the American Medical News report, the co-pay rules allow for exceptions, letting insurers charge a co-pay when a patient is enrolled in a "grandfathered" health plan that is not subject to health reform's mandates. The exceptions also apply if the physician is out-of-network for the patient plan or if services for another problem are provided during the same visit.
Read the American Medical News report for more details on the co-pay regulations.
Related Articles on Coding, Billing and Collections:
Colorado Becomes Eighth State to Set Up Health Exchange
Plan to Privatize Medicare Voted Down in Senate
Webinar Discusses Maximizing Reimbursement in Surgery Centers