Part B Insider (Multispecialty) Coding Alert

OFFICE MANAGERS:

Fire Your Patients--Without Getting Burned

5 tips to avoid legal pitfalls in discharging deadbeat beneficiaries

Delinquent patients don't have to be a permanent fixture in your practice. If you have patients who owe thousands of dollars in copayments and deductibles, you don't have to keep providing them with care, say experts.

Confusion: Some practices may feel tempted to charge their patients a -statement fee- or interest charge for long-overdue bills, but this can open up a compliance can of worms, say experts. (See PBI, Vol. 7, No. 10.) They say one alternative is to -fire- non-paying patients. However, some providers worry that this could lead to a whole other set of legal nightmares.

Your biggest concern in   discharging deadbeat patients is that the patient might charge you with -abandonment,- says attorney Alice Gosfield with Alice Gosfield & Associates in Philadelphia, PA. You are not required to see a patient who won't pay, but you could face an abandonment lawsuit. Here are some suggestions for avoiding this fate:

1)  Help your patients find other resources. You can tell a deadbeat patient that the relationship isn't working because he/she hasn't fulfilled his/her obligations and you -can't establish an effective doctor-patient relationship,- notes Gosfield. Then, tell the patient: -But here are some other folks you might consider,- she suggests.

2)  Give adequate notice. For a typical patient, you should provide 30 days- advance notice in writing, advises Jill Young with Young Medical Consulting in East Lansing, MI. Send a certified letter notifying the patient of the deadline to find another practice, and continue treating the patient during that 30-day period.

3)  Pay attention to state laws. Some states may have unique abandonment laws that you have to obey when discharging a patient, warns Gosfield.

4)  Pay attention to circumstances. Patients in rural or underserved areas may need longer than 30 days to find a new provider, says Gosfield. Also, if the patient has insurance that few providers will accept, then the situation may not be so simple.

5)  Check your participation agreement. If the patient belongs to a health plan  and you-re a participating provider, then your agreement may specify  how you can get rid of a non-paying patient, Gosfield notes. You may have to approach the medical director of the health plan and ask to transfer the patient out of your panel.