Pulmonology Coding Alert

Question: We recently had a consultant come in to evaluate our accounts receivables and collections. She said we should start keeping a credit card on file for patients, and then having them sign a document noting that we can charge the balance to their cards if they don’t pay it. What should we get from them other than the credit card numbers?

Nevada Subscriber

Answer: Having a card on file removes an obstacle to receiving payment, and patients knowing that a card is on file adds a layer of financial responsibility. They can’t just ignore the balance. Make sure that your patients sign a pre-authorization form. Your form should include:

• The patient’s name
• Type of credit card
• Billing address
• Credit card number
• CVC on the back
• Expiration date

The form can also allow the patient to elect to be billed by a mailed paper statement with the stipulation that if payment is not received by the due date, then the credit card on file will be charged. Be sure to use HIPAA-compliant emails and online payment portals. Here are a few additional best practices when keeping credit cards on file:

• Keep it simple and direct to avoid offending your patients. Put it in your financial policy in bold print and explain it as a service to help avoid billing hassles when the remaining balance comes due.
• Inform patients of account balances after the insurance responds to avoid surprising them with charges. Let them know that you would like to bill for the balance to the card within 48 hours. Treat it as a courtesy and give them time to provide another form of payment.
• Scan credit card information into your EHR and destroy hard copies for an added layer of security. Call your merchant services company (the one that gave you the card readers) to ask about features that protect stored information. This not only streamlines the process but also transfers the security responsibility.
• Be firm and consistent with this policy in the face of opposition. Don’t present it as an option, but be willing to address it on a case-by-case basis. Some patients aren’t certain of their future financial stability and simply will not comply with the policy. You can provide an alternative, if needed, such as having them sign a financial responsibility form that promises to pay within 15 days of receiving the bill.