Wiki Patient Registration Forms

[arrana]

My question is can we bill for a patient visit if we do not have the patient registration forms on file? Obviously it's best practice to have completed registration forms, but is it required?

Let me offer a scenario: New patient comes in for a same day visit for an acute condition while they are on vacation (our clinic is in a resort area - this happens all the time). The patient is handed a registration packet, we scan a photo ID, get a copy of the insurance card, and verify eligibility. The patient is then called into the exam room prior to returning the completed registration forms. The provider sees the patient, treatment is complete, patient leaves without checking out (goes out the back door, or whizzes by the busy checkout desk). Intake forms are nowhere to be found (maybe patient took them, maybe they are lost in the office, maybe they were accidentally shredded). Provider documentation of the visit is excellent. Can we bill this visit to the patient's insurance? Does it make a difference if the patient is a minor?

Looking for credible sources to substantiate either billing or not billing.

Thanks,
Arrana Ashton, CPC, CEMC, CPMA

 

[thomas7331]

I think the answer would really depend on which forms are missing from the record. Most patient registration forms (e.g. consent to treatment, notices of privacy practices or patient rights) are required for legal and regulatory reasons that are unrelated to billing. The exception might be an assignment or benefits or authorization to bill insurance - if your facility uses something like these, you might consider a policy of billing the patient directly if you don't have the form on file, so that the patient would contact you to provide the necessary authorization.

But the bigger picture of failure to have patients complete required paperwork, or failure to keep those records in the chart, could have more serious liability implications for the practice that aren't going to be rectified by simply not billing for the services. Facilities I've worked for, except in the case of an emergency, would not treat a patient who did not complete the required forms, let alone bill for it. If this is something you're seeing, I'd think it should go to a manager or compliance officer to review and address and not be decided in billing or coding unless your organization sets a policy and procedure to follow with regards to how they want it handled.