Collecting co-pays at the ED registration desk.

[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.

[Rob72, ASN, RN]

If this original poster is still on here now 6 years after the original post - I'm just wondering, how did this work out for you all?

Unless it was implemented, or some other revenue process came along, I would guess unemployed. See-the-indigents-for-free killed most of the community hospitals in S. Texas and Arizona.

[Guest219794]

i guess it's all in the way it's handled... a few years back, when i was in nursing school, i was assaulted in the parking lot of my workplace (not a hospital) and since i had been hit in the head, my boss brought me to the er to get checked out. i felt ok but i had been hit pretty hard in the head, twice, so i went. on discharge, i was not asked if i would like to pay my copay or part of it and be billed for the rest, i was told by the rather abrasive lady at the discharge desk that my insurance had a copay and how would i be paying it today?

i was in nursing school, working part time, we were on a really strict budget- i had a credit card i carried for emergencies, and i used it. good planning. (and i was a little po'd at my boss for dragging me to the er if your head injury was so severe as to render you unable to make your own decisions, it's a good thing you went to the er. a change in mental status following a blow to the head needs immediate evaluation. instead of sending me home where i could see my regular doctor without the gaint copay, but hey, i don't work for her anymore)

anyway, my point is, i can see how tense situations could arise in these billing situations and why some people may not be eager to see it implemented.

er's are an expemsive way to provide care.

[Guest219794]

We are not a locked down unit- we have entrances and exits at both sides of the ED, there will not be any added staff, we are already fighting for staff, and we are not a grocery store.

Stems from an inabilty of administrators to do simple math:

If a person's work day is full, and you add a task, they will need to stop doing something else. Or, they will need to devote less time to a task they are already doing, with a drop in the quality of work.

They either A- miss this simple concept, or B- think your staff is goofing off, and could be more effcient. Why not ask them which?