Write Off Policy
Purpose
To ensure the proper procedure is utilized when removing uncollectable accounts from the accounts receivable balance.
Policy
Claims identified as uncollectable will be adjusted off for services that have aged two years from the DOS, unless otherwise specified throughout this document, including small balances at payer ($10 or less). Write offs will be coded based on the specific denial reason associated.
Policy excludes:
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MVA, Litigation, Facility, Invoice, or Patient Responsibility.
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Claims within the reconsideration process or appeal process.
Definitions
Write Off
Any dollar amount deducted from a medical bill.
Uncollectable Write-Offs
Unforeseen adjustments incurred due to errors in clinical workflow, insurance determinations and/or follow-up processes.
Timely Filing
- Claim filed past the date required by the payer and all appeal rights exhausted.
Credentialing
- Filing a claim for a provider before they are credentialed with the payer.
Administrative
- Registration errors
- Benefit/eligibility verification
- Out-Of-Network vs. In-Network
- Authorization related
- ICD-10 or CPT code errors
- Payer changes
Small Balance Payer write-offs (managed by Clinicient)
Amount left on a claim balance ($10 or less) at payer that is unable to be moved to patient that has exhausted the established RCM policy efforts (i.e., Medicaid, MVA).
Patient Collections (workflow managed by the client)
Patient balances sent to a collections agency to pursue for further collection. After claims are sent to a collections agency, they are to be written off immediately in the Insight software, unless otherwise specified.
Collectible Write-Offs
Write-offs that have been agreed to, either in the context of a contract or in terms of a practice philosophy.
Contractual
- Involve the differences between the practice fee schedule and the allowable fee schedule a practice has agreed to accept.
Patient Hardship (managed by clinic)
- When a patient is in financial need and thereby incapable of paying, such write-offs may be in accordance with financial assistance programs (patient hardship paperwork must be on file).
Small Balance Patient write-offs (managed by clinic)
- Amount left on a patient's account may not warrant the cost of sending a bill. Many practices write off the small balance (usually $10 or less) and collect it when the patient returns. Others run a special small balance statement, usually once a quarter.
Prompt payment discounts and self-pay (no insurance) discounts (managed by clinic)
- Patients who receive discounts for paying in full at the time of service or because they do not have insurance coverage.
Why
To ensure that a clinic can forecast collectable dollars.
Clinicient (the “Company”) is providing this information for general guidance. The application, impact and change of laws can vary widely. Accordingly, the information is provided with the understanding that it is not offered as legal or any other professional advice or services and as such should not be used as a substitute for consultation with professional and licensed advisers. While we have made every attempt to ensure that the information contained herein is accurate at the published time, the Company is not responsible for any errors or omissions, or for the results obtained from the use of this information. All information is provided "as is," with no guarantee of completeness, accuracy, timeliness or of the results obtained from the use of this information, and without warranty of any kind, express or implied, including, but not limited to warranties of performance and fitness for a particular purpose. In no event will the Company or its subsidiaries, agents or employees thereof be liable to you or anyone else for any decision made or action taken in reliance on the information.
