[mommatrauma]

We do it...If you have the money you pay, if not, you're billed..works out fine...Haven't heard any complaints...

[pkapple]

I work at a very rural ed. We have an admission clerk so to speak until 11pm. After 11p, we check them in on paper forms, copy id and insurance cards, triage, treat, medicate, transfer or discharge. I do not have every insurance rate, I don't even have the computer up, but I can read an insurance card that says ER COPAY 100. If I am not in the middle of a crisis I will ask the patient if they are paying the co-pay, if they have no insurance, I have them sign a promissary note for 25 a month til this visit is pd in full.
I don't ask up front, it is part of the discharge after 11p, when admission clerk is on I ask them to check with her---we don't chase any one down or threaten to lock them up. If being asked to pay your co payment offends anyone-I'm sorry, but I would hope people have some idea of how their insurance works. My husband had a heart cath in January, I am still paying off the copay of 20% which with our 500 deductible(being Jan) amounted to over 2600 bucks. I knew we would have to pay but was a bit surprised at the amount, nevertheless, I am making payments.

[EMTtoRN]

I work as a registrar part time in the ED and collection of copays goes like this:
1) We ask upon registration whether or not they would like to pay their copay at that time. We have both a cash box and a credit card machine to process payments.
2)During the hours of 9-5 M-F we have a financial counselar that also follows up on copays.
3) If the copay is not paid they are billed for it.

I think the process works very well.

Originally Posted by TlhRNED

Our facility is suggesting that we start collecting co-pays on insurances at the ED registration desk upon discharge. I am completely against this... Any feedback out there?
To add clarification here... we do not have a locked ED. We are a small rural ED and this task is one they want to add to my registration/secretarial support staff, of which there is only one 24/7. We do not have a policy where patients go to a discharge desk or window. There are several different people who function in the registration and secretarial role and I have concerns for them.

[nursejennie76]

At my ER certain patients are flagged in the computer when they come in, I am sure it depends on there insurance. And when they are discharged they go to a financial counselor that has a office in the ER. They are ont required ot pay at that time but they can if they want to or make other arrangements. I think this is a good thing because sometimes bills are overlooked when you get them in the mail and you will remember to pay if you have talked ot someone face to face. Jennifer

[ryoung0302]

This goes to Dixielee, you are saying it perfect, You dont know how many times I have asked patients that same question. Most of the time they look at me like I am crazy, but then again you have to be to work in most ERs.

To TlhRNed, I understand where you are cmoing from, but you have to understand how much money is lost by people not paying their copays. I have been working in an ED for the 8 years and we have a standing rule that upon discharge the chart is walked either by a nurse or tech to the discharge desk and they are called up there to recieve all their paperwork. This has really increased our copayments, and actually helped us to make budget a couple of times. I am in a big city so most of the time we are used as a doctors office when people cant see their PCP. It has nothing to do with being rude to the patient, but you have to get somemoney somewhere.

Hope you are able to get it all worked out.

[needsmore$]

We also collect copays at discharge- community hospital- about 38,000 visits/year. Doing this has decreased a lot of lost revenue for our facility! Echoing Dixielee-this is not a nursing function, also- we do bill if needed but we accept credit cards.

I know the ED is for "accidents and ---god forbid- emergencies"; and many may not have money at the time- for MVAs, workers comp injuries there is no copay- that's why we do bill if needed. If people are starting to use the ED as another or instead of the"doctor's office"- then they should expect to start paying for services.

I also believe that private physicians who refer patients to the ED to be seen because of whatever reason ( no appt time available, need additional tests, etc) need to tell these patients that they will be expected to pay the ED copay $$$. I have seen many get upset because they paid their office visit $$$, referred to the ED for the ED doc second opinion and some lab/xrays, get discharged and get hit with usually a higher ED copay!

Happy Memorial Day-be safe all
Anne

[candyndel]

Everyone is moving to collecting co-pays at discharge. (We generated $40K last year by doing so.) We also sign patients up for chartity care at that time and verify their demographics.
Its inevitable, so dont fight it (and you as the nurse wont be doing it). Do a lit search and you will see all the articles that have been recently published about it in favor of it.

[canoehead]

If you are uncomfortable totaling the charges for that day's care a good solution would be to look into the account and see if there are charges outstanding. Ask them if they would like to make a payment on their outstanding balance. You'll be rewarding those that pay promptly with a quick and easier discharge, and letting your repeat offenders know that what they owe is not forgotten and forgiven as soon as they walk out the door.