Billing, Collections Policy & Procedure

POLICY:

After our patients have received services, it is the policy of UF Health Flagler Hospital to bill patients and applicable payers accurately and in a timely manner. 在此计费和收款过程中，工作人员将提供 quality customer service and timely follow-up, and all outstanding accounts 将按照美国国税局和财政部的501(r) final rule under the authority of the Affordable Care Act.

PURPOSE:

这项政策的目标是提供明确和一致的指导方针 以一种促进 compliance, patient satisfaction, and efficiency. Through the use of billing statements, written correspondence, and phone calls, UF Health Flagler Hospital will make diligent efforts to inform patients of their financial responsibilities 以及可用的财政援助方案，以及跟进 patients regarding outstanding accounts. Additionally, this policy requires UF Health Flagler Hospital to make reasonable efforts to determine a patient’s eligibility for financial assistance under UF Health Flagler Hospital’s financial 从事特别催收行动前的援助政策 to obtain payment.

DEFINITIONS:

Extraordinary Collection Actions (ECAs): 一份由美国国税局和财政部定义的收款活动清单 卫生保健机构只能对个人采取行动以获得 在作出合理的努力确定后支付照顾费用 个人是否有资格获得经济援助. These actions are further defined in Section II of this policy below and include actions such as reporting adverse information to credit bureaus/reporting agencies 以及诸如扣押工资等法律/司法行动.
Financial Assistance Policy (FAP): A separate policy that describes UF Health Flagler Hospital’s financial assistance 项目，包括患者必须满足的标准 eligible for financial assistance as well as the process by which individuals may apply for financial assistance.
Reasonable Efforts: 医疗保健机构必须采取的一系列行动来确定 whether an individual is eligible for financial assistance under UF Health Flagler Hospital’s financial assistance policy. In general, reasonable efforts 可能包括推定是否有资格获得全额 或部分协助，以及为个人提供书面和 oral notifications about the FAP and application processes.

PROCEDURE:

I. Billing Practices

A. Insurance Billing

1. For all insured patients, UF Health Flagler Hospital will bill applicable third-party 付款人(根据患者提供的信息或经患者核实的信息) in a timely manner.
2. 如果付款人因电子邮件上的错误而拒绝(或不处理)索赔 our behalf, UF Health Flagler Hospital will not bill the patient for any amount 超出了如果付款人支付了索赔，病人所欠的金额.
3. If a claim is denied (or is not processed) by a payer due to factors outside 在我们组织的控制下，工作人员会跟进付款人 并尽可能耐心地协助解决索赔问题. If resolution does not occur after prudent follow- up efforts, UF Health Flagler Hospital may 给病人开账单或采取其他符合现行规定的措施 and industry standards.

B. Patient Billing

1. 所有没有保险的病人都会直接及时地收到账单，他们会 接收作为组织正常计费流程一部分的对账单.
2. For insured patients, after claims have been processed by third-party payers, UF Health Flagler Hospital will bill patients in a timely fashion for their respective 责任金额由其保险收益决定.
3. All patients may request an itemized statement for their accounts at any time.
4. If a patient disputes his or her account and requests documentation regarding the bill, staff members will provide the requested documentation in writing 在10天内(如果可能的话)，并将持有账户至少30天 days before referring the account for collection.
5. UF Health Flagler Hospital may approve payment plan arrangements for patients who indicate they may have difficulty paying their balance in a single installment.
   1. Patient Financial Services Management has the authority to make exceptions 在特殊情况下，根据具体情况执行本政策.
   2. UF Health Flagler Hospital is not required to accept patient-initiated payment arrangements 并可将帐户转介给如下所述的催收机构 patient is unwilling to make acceptable payment arrangements or has defaulted on an established payment plan.

II. Collections Practices

A. 在遵守相关的州和联邦法律，并按照 与本账单和收款政策中概述的条款, UF Health Flagler Hospital may engage in collection activities—including extraordinary 收集行动(ECAs) -收集未偿还的患者余额.

1. 一般催收活动可包括[对报表的跟进查询]
2. 患者余额可转介给第三方收集在 discretion of UF Health Flagler Hospital. Accounts will be referred for collections only with the following caveats:
   1. 有合理的理由相信病人欠了这笔债.
   2. 所有第三方支付方均已妥为结算，剩余债务也已付清 is the financial responsibility of the patient. UF Health Flagler Hospital shall not bill a patient for any amount that an insurance company is obligated to pay.
   3. UF Health Flagler Hospital will not refer accounts for collection while a claim on the account is still pending payer payment. However UF Health Flagler Hospital may 如果某些要求被卡住，将其归类为“拒绝” 在"待定"模式中等待不合理的时间，尽管 efforts to facilitate resolution.
   4. UF Health Flagler Hospital will not refer accounts for collection where the claim was denied due to a UF Health Flagler Hospital error. However, UF Health Flagler Hospital may still refer the patient liability portion of such claims for collection if unpaid.
   5. UF Health Flagler Hospital will not refer accounts for collection where the patient has initially applied for financial assistance or other UF Health Flagler Hospital sponsored program and UF Health Flagler Hospital has not yet notified the patient (如果患者遵守了时间表) 以及在申请过程中描述的信息要求).

B. 合理努力和特别催收行动(eca)

1. Before engaging in ECAs to obtain payment for care UF Health Flagler Hospital must 做一些合理的努力来确定一个人是否 有资格根据我们的资助政策申请资助的人士:
   1. ECAs may begin only when 120 days have passed since the first post-discharge statement was provided.
   2. However, at least 30 days before initiating ECAs to obtain payment, UF Health Flagler Hospital shall do the following:
      1. Provide the individual with a written notice that indicates the availability 列出可能获得的经济援助计划 支付护理费用，并给出启动eca的最后期限 (不早于第一张出院后帐单后120天) and 30 days after the written notice)
      2. Provide a plain-language summary of the FAP along with the notice described above
      3. 尝试口头告知患者FAP的情况，以及他或她如何 may get assistance with the application process
2. After making reasonable efforts to determine financial assistance eligibility as outlined above UF Health Flagler Hospital (or its authorized business partners) may take the following ECA to obtain payment for care:
   1. Report adverse information to credit reporting agencies and/or credit bureaus
3. 如果患者对先前提供的护理有未偿还的余额, 佛罗里达大学健康酷游九州真人可以从事延期的ECA, denying, or requiring payment 在提供额外的医疗必要(但非紧急)护理之前 only when the following steps are taken:
   1. UF Health Flagler Hospital provides the patient with an FAP application and a plain language summary of the FAP
   2. UF Health Flagler Hospital provides a written notice indicating the availability of financial assistance and specifying any deadline after which a completed 不再为先前的护理事件申请援助 be accepted. 该截止日期必须在通知日期后至少30天 或在第一次出院后240天内对账单进行事先结算 care—whichever is later.
   3. UF Health Flagler Hospital makes a reasonable effort to orally notify the individual about the financial assistance policy and explain how to receive assistance with the application process.
   4. UF Health Flagler Hospital processes on an expedited basis any FAP applications for previous care received within the stated deadline
4. 患者金融服务最终负责确定是否 an individual is eligible for financial assistance. This body also has 决定组织是否可以继续进行的最终权力 any of the ECAs outlined in this policy.

III. Financial Assistance

All billed patients will have the opportunity to contact UF Health Flagler Hospital 关于他们账户的财务援助，付款计划选择， and other applicable programs.

1. UF健康酷游九州真人的财政援助政策是免费的 of charge.

Request a copy:

• 亲自到佛罗里达大学健康酷游九州真人的任何注册地点
• By calling the Billing Department/Financial Advocate 904-819-4539 or mailing a request 2155 Old Moultrie Rd Suite 103, St. Augustine, FL 32086
• Online at http://www.flaglerhospital.org/
  • Individuals with questions regarding UF Health Flagler Hospital’s financial 援助政策可以通过电话联系财务咨询办公室 at 904-819-4539 or in person at 400 Health Park BLVD, St. Augustine, FL 32086

IV. Customer Service

A. During the billing and collection process, UF Health Flagler Hospital will provide 通过实施以下准则，为客户提供优质服务:

1. UF Health Flagler Hospital will enforce a zero tolerance standard for abusive, harassing, 雇员的冒犯性、欺骗性或误导性的语言或行为.
2. UF Health Flagler Hospital will maintain a streamlined process for patient questions 和/或纠纷，其中包括一个免费电话号码，患者可以 电话和一个显眼的商业办公室地址，他们可以写信给你. 这些信息将继续列在所有病人的账单和收款单上 statements sent.
3. 在收到病人的沟通(电话或书面)后， UF Health Flagler Hospital staff will return phone calls to patients as promptly as possible (but no more than one business day after the call was received) and will respond to written correspondence within 10 days.
4. UF Health Flagler Hospital will maintain a log of patient complaints (oral or written) that will be available for audit.