Podiatry Coding & Billing Alert

Question: My podiatrist never wants to write off any patient bills, but I am afraid he's expending more effort than it's worth trying to collect. What's your best advice for determining a write-off?

New York Subscriber

Answer: Of course, you should resort to a write-off when all other collection methods, including discounts, payment plans, etc., have failed. If you are encountering the following situations, a write-off may be justified:

1. The cost of collecting a balance is more than what the patient owes. For example: A patient's balance due is $3 after all insurance payments. The administrative cost to bill and collect is at least $15 per statement.

2. The provider has used all available methods to try to collect,including submitting the account to a collection agency.

3. The patient files for bankruptcy. This does not always mean a write-off, however. The court could establish a payment plan based on available assets. If you do receive a discharge of debtor notice, you would then write off the debt.

4. If the patient has Medicare, but you did not collect a signed Advance Beneficiary Notice of Noncoverage form for the specific date of service, and, thus, there is no GA (Waiver of liability statement on file) modifier on the claim. In this case,you will not be allowed to balance bill. So if Medicare won't pay the claim on the basis of medical necessity, you will be forced to write off the charges.

5. If the terms of your contract with the insurance company state that you cannot balance bill the patient if a claim is denied.

6. The patient proves financial hardship, which will require you to request documentation of all forms of income, assets, income tax returns, W-2 and 1099 forms to determine whether the patient's earnings meet state and federal poverty guidelines.

-- Answers to You Be the Coder and Reader Questions were reviewed by Arnold Beresh, DPM, CPC, of Peninsula Foot and Ankle Specialists PLC in Hampton, Va., and Richard Odom, DPM, CPC, AOPS, practicing podiatrist at Gulf Coast VA Hospital System in Mobile, Ala.