22 May Medical Debt Mediation Program for Healthcare Providers and Patients
Announcement: New affordable Medical Debt Mediation Program to help healthcare providers and patients resolve medical billing past due balances
With the rise of high-deductible policies and the future of affordable health insurance uncertain, healthcare providers are faced with increasing amounts in outstanding self-pay account balances. Traditionally, a provider will make multiple attempts to collect on a debt and then send the past due accounts to a collection agency. Unfortunately, collection agency rates of recovery have only been 15% – 20% on average. For those amounts that are collected, providers are charged a hefty commission and other fees. If not collected, the balance is either deemed uncollectible or other legal actions are pursued.
The sole use of mail, email, and phone communications do not yield the desired results. It is easy for patients to disregard these attempts. Every day the balance remains outstanding, the probability of collection deteriorates. Not only is the money not collected, but time and efforts are wasted. Further, the trusted patient/provider relationship is undermined by what is often perceived as an adversarial collection process.
Medical providers are understandably reluctant to put financial pressure on their long-term or sick patients. Both patients and providers may benefit from other widely used methods of account resolution that focus on preserving the relationship while collaborating on a mutual agreement.
A FRIENDLIER APPROACH
Before sending an account to a collection agency, providers and patients have an opportunity to engage in settlement negotiations. For some providers, government regulations require that reasonable and genuine collection efforts be made. This is coordinated by the provider or their billing company initially. If the account remains outstanding, a neutral third party can help mediate an agreement. This may be a more effective next step than traditional collection practices.
Mediation is a voluntary and confidential alternative dispute resolution (ADR) process where the parties informally discuss issues and explore solutions in a respectful environment. In Florida, mediators are certified by the Florida Supreme Court after meeting educational requirements, participating in mentorship training, and passing a background check. They must adhere to ethical rules or be subject to disciplinary sanctions. Their role is to act as an impartial facilitator and they do not advocate for either party. While there is no guarantee, historically mediation has a high success rate and most participants report having a positive experience.
Discussions in mediation are confidential, except in limited instances where required or permitted by law. These statutory requirements are very strict. Whatever is said in mediation cannot be shared with outside persons, the public, or even in court. For example, settlement offers cannot be used as evidence and mediators cannot be called as a witness. The point is to create a safe place where both parties have the freedom to speak and make offers without fear of it being used against them.
All decisions are made by the parties and both parties must agree to all terms. The mediator does not make any decisions or give legal advice. There are four possible outcomes: agreement, impasse, stipulation, or continuance.
Agreement – both parties agree to payment or other terms. It is put in writing, signed and generally binding
Impasse – the parties do not agree and may proceed with other courses of action
Stipulation – everyone agrees to a final solution such as a write-off or a judgment to stop future collection attempts
Continuance – there is no agreement, but both parties would like to try mediation again at a later date
An early determination can help both the patient and provider understand how to proceed, such as whether payments will be made, the account is uncollectible, or extraordinary collection actions such as credit reporting, judgments, liens, and wage garnishments are needed. This removes uncertainty and reduces the time, effort, and money expended in the collection process.
To make this possible, we have developed an affordable medical debt mediation program.
Read the full whitepaper: Medical Bill Mediation
Getting started is easy. We will meet with you to discuss your needs and answer any questions. Both the patient and the healthcare provider will need to sign an Agreement to Mediate and set an appointment date. We are happy to sign any necessary HIPAA Business Associate Agreements. Meetings will be held at your facility and typically take an hour or less. All that is needed is a private conference room, the person responsible for payment, and a provider representative who is fully authorized to make payment agreements. Parties can appear by telephone so long as everyone agrees. The forms you already have for payment arrangments can be used. If a patient brings a payment with them, you can process that as normal. Mediators never handle any money exchanged between the parties. Simple.
ABOUT CHRISTINA M. DURTA, CHFP, CPA, MST
Christina is a located in Panama City, FL. Her practice is focused on healthcare, insurance, and litigation matters. She is a Florida Supreme Court Certified Circuit and County Mediator, a Certified Public Accountant, and a Certified Healthcare Financial Professional. Educationally, she has a Masters in Taxation, BS in Business with High Distinction, and graduated from a medical coding program with honors. She is also licensed as a Mediator of Claims for the Florida Department of Financial Services, a Life, Health, and Annuity Insurance Agent, and as an All-Lines Adjuster.
To learn more, please call Christina at 850-340-0581, send an email to email@example.com, or visit our website at nontraditionalcpa.com