# upfront collections not permitted by insurance



## JesseL (Dec 16, 2015)

I was wondering how people are dealing with insurances that does not allow you to collect a deposit up front from the patients.  

Insurances such as FidelisCare and Empire BlueCross BlueShield specifies that we're not allow to collect anything from the patient until the claim is processed EVEN though we know that it will go towards their deductibles and the patient likely will "dine and dash."

I send some patient's to collections, even make them sign a financial agreement that they would be responsible for collection fees, but it hasn't really been successful.


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## ahefner (Dec 16, 2015)

I do not collect "deposits" from a patient up front but after running an estimation of benefits, it is well within MOST insurance contracts between the insurance company and the provider for a collection of a patient's estimated deductible/coinsurance/copayment. What is usually not allowed is a blanket requirement of a deposit without an estimation of benefits being performed. Please check the actual provider contract as well as the payer's medical billing manual to see what is actually stated towards this. You are correct that the upfront collection of a patient's responsibility for their care is the best practice!


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## mitchellde (Dec 16, 2015)

The insurance I have does not allow for collection of copay at the time of service, it must be billed.  The only thing you can do is bill the patient. But do let the patient know you are billing the copay.  My problem is the physicians would send the bills in plain envelopes and I threw them away thinking they were spam!  It took me awhile.


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## Billing2012 (Dec 16, 2015)

*Upfront collections*

I do collect upfront after running a caracal. In fact Blue Cross offers a service to link you directly to a cc charge. I also worked for a practice that requested a cc upfront and bill the cc upon receiving the eob. How else can doctors stay in business and pay their staff.


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## mitchellde (Dec 16, 2015)

Most insurances allow you to collect up front. However there are plans that do not allow this.  And if the plan does not allow it, then the provider has no choice but to bill the patient.


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## JesseL (Dec 16, 2015)

Billing2012 said:


> I do collect upfront after running a caracal. In fact Blue Cross offers a service to link you directly to a cc charge. I also worked for a practice that requested a cc upfront and bill the cc upon receiving the eob. How else can doctors stay in business and pay their staff.



The problem with that is there are patient's that are A-holes that would call their credit card to dispute it. It has happened before over a cosmetic cream  for treating skin discoloration that a patient bought from us and he didn't like it (idiot that expected to see magical results after a day of use) and he demanded a refund.  Of course we denied him because he opened it and used it and was too dumb to understand he had to use it consistently for it to work. He went and dispute his credit card and they took the money back from us for the $80-$100 expensive skin care product.

Goes to show how easy it is for them to dispute a charge if they wanted to.  

Worst of all some of these types of patients can live with having the collection agency ruin their credit even if I report them to one.  After 5 years, the record is wiped off from their credit report anyway.

We even have patients that say they want treatment but they wont pay for it (after explaining to them what a deductible is).

Which brings another question if a patient can sue us for not treating them because they flat out said they wont pay for it if it goes to their deductible.

We've had so many dine and dash patients because insurance companies allows them to.  Insurances are probably laughing because they got the patient's premiums while they don't have to pay a dime for patient's unreachable high deductible plans.


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## SCHAUFLER (Dec 18, 2015)

You can dismiss them from practice.


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