Most ambulatory surgery centers (ASCs) occasionally encounter a patient with no insurance or physician who wants to perform a procedure not covered by insurance.
If you want your ASC to perform such procedures and collect a full payment from patients, ensure you follow these seven steps.
1. Secure permission from management to schedule self-pay procedures.
2. Develop a board-approved, self-pay financial policy. This policy should include how to categorize a self-pay patient, what type of discount for full payment is allowed and if the center will allow payment plans.
3. For every self-pay procedure, ask the physician's office how it is handling the patient's responsibility. Is the physician discounting his or her fee? Does the patient require charitable assistance?
4. If the patient is not eligible for charitable consideration, advise the patient that the center requires payment in full prior to or on the date of service. If the patient is eligible for charitable consideration, advise the patient of the reduced rate that will be owed prior to the procedure. Provide the patient with your ASC's acceptable payment options (e.g., cash, credit card, money order, healthcare finance).
5. If the patient agrees to pay in full prior to the procedure, and if allowed by your financial policy, offer the patient a discount. This discount amount, usually a percentage, should be clearly stipulated in your self-pay financial policy and represent the standard payment-in-full-prior-to-surgery discount for everyone.
6. If the patient cannot afford full payment on the date of service and your ASC's self-pay financial policy permits payment plans, ask the patient to sign a promissory note.
The following are sample payment plans, listed in order of preference:
• 50% at admission and payment of the remaining 50% in 30 days
• 50% at admission, 25% in 30 days and 25% in 60 days
• 33% at admission and 33% in 30 days, with the final balance in 60 days
• 25% at admission and the remaining balance paid in six equal monthly installments (six months total)
7. Document all arrangements in your billing system. Fully describe the payment plan and add follow up on any outstanding payments still to be made to your tickler system.
ASC self-pay key takeaway
For most surgery centers, self-pay patients are infrequent occurrences. However, if you intend to provide care to these patients, it is essential that appropriate, comprehensive financial policies and rules are put in place and always followed.
Caryl Serbin, RN, BSN, LHRM, is president and founder of Serbin Medical Billing, an ASC revenue cycle management company. Serbin Medical Billing's primary objectives are to provide the best coding, billing and accounts receivable management services available to ambulatory surgery centers (hospital joint-venture, corporate-owned or independent) and anesthesia providers. Ms. Serbin has been a leader in the ASC industry for 30 years. She was the founder of the first ASC-specific billing company.