Providers Should Implement Sound Procedures To Address Co-Pays and Deductibles


Providers can not only directly hurt their practice’s financial well-being by waiving co-pays and deductibles, but they may be committing insurance fraud and abuse as well. Andria Jacobs, the chief operating officer for PCG Software, writes that patients are ultimately responsible for deductibles and co-payments. Overwhelming use of services and items paid for by Medicare, false claims and Anti-Kickback Statute violations are the results of providers unlawfully waiving co-insurance requirements. A patient’s financial hardship should be the only legitimate reason to waive co-pays and deductibles: proof of cost of living, medical bills and family size need to come in the patients’ own handwriting. Ms. Jacobs says, “To avoid any impropriety and keep their practice—not to mention patients—healthy, providers should implement and enforce sound policies and procedures that address the issue of co-pays and deductibles.” To read more on this topic and to visit the Office of Inspector General’s website for information on the Anti-Kickback Statute, head here.


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