Co-pays in the ER - page 2
We have been told our registration clerks will be starting to collect insurance co-pays from pt's after services are rendered. Just wondering if any other ER's out there are doing this and how it is... Read More
Sep 1, '01Occupation: ER NURSE/TNC Joined: Feb '01; Posts: 4do not forget about the legalities here. you must treat the patient before collecting money...in SC you cannot discuss payment with the patient. i personally do not believe that this should be a nursing responsibility--nor would i advice anyone (nurse) to participate in the activity due to legal ramifications
Sep 2, '01Joined: Mar '01; Posts: 1,898; Likes: 37KHERNSE
Copays are obtained after the pt is discharged. It is not a nursing responsiblity. They are collected by the registration clerk. The nurses do not discuss payment with the pt. Pts are always treated regardless of their ability to pay.
Sep 3, '01Occupation: Clinical Leader Specialty: ER, Hospice, CCU, PCU ; Joined: Jul '01; Posts: 799; Likes: 51We have always figured that if we could just post someone in the waiting room with a pack of work excuses we could charge 5 dollars and greatly reduce the the number of patients seen.
Sep 4, '01Occupation: RN, ER Supervisor Joined: Jul '00; Posts: 48; Likes: 1Originally posted by debbyed
We have always figured that if we could just post someone in the waiting room with a pack of work excuses we could charge 5 dollars and greatly reduce the the number of patients seen.
These people are the majority that comes to the ER on Thursday nights and Sunday. Never having a "True" emergency. As you give them their discharge instructions they will say "Oh yeah, I need an excuse". Sometime I just want to say....there is no excuse..... lol JUST KIDDING!!!
Sep 5, '01Occupation: RN Specialty: ER, PACU, OR ; Joined: Dec '98; Posts: 2,120; Likes: 28Co-Pays were such a big issue........we have nothing to do with it yet?
Oct 29, '01Occupation: rn - ed Joined: Apr '00; Posts: 21; Likes: 1Oue ED starts collecting copays in the next couple weeks. a registration clerk will meet with patients after discharge to discuss payments and make arrangements.
The hospital has actually hired an outside company to start this up. I guess the dept lost around 5 million dollars last year in uncollected copays and other monies...
maybe i will see this $$$$ in my check.. NOT !!
we are also stopping ALL cab vouchers. YEAH!
last month a lady called in to the department to have a cab voucher ready to pay for her ride in also !!!! .
we will have some bus tokens available.
No more healthy choice meals for the hungry.
Nov 5, '01Occupation: Emergency department Joined: Aug '01; Posts: 509; Likes: 2Our upfront charge (after Medicare rebate) is up to $90, which is explained to the pt by the receptionist before anyone sees them (unless they are a Code 1 ambulance case). So why do we still get people coming in the middle of the night because their newborn baby is "making snuffly noises and moving around" while they are sleeping? Believe me, a co-payment makes no difference to the amount of rubbish you will get through the door!
Nov 6, '01Occupation: Charge RN 7p-7a 19 bed ER (soon to be 27 beds!!!) Joined: Jun '01; Posts: 29Our hospital also wants the nurse to escort the patient to the registration/cashier's area for "financial" checkout after the discharge paperwork is signed. We have increased our collection of debt - which may not directly impact my paycheck - but with hospitals going belly up because of finances... at least I have a job and a place to work. Another thing they have started doing is showing the bill for services to self-pay (read: no insurance or funding) patients, and giving them 48 hours to make an offer to pay something (priceline.com in the ER !). My understanding is that any amount of money is preferable to nothing... Haven't heard whether this has worked yet or not. I'll let you know. I don't have a problem escorting any one to the registration, and I have had only 1 patient's family get nasty (told me "Bill me, they always just bill me!")
Nov 15, '01Occupation: rn Joined: Nov '01; Posts: 7Hey DanRN - please don't stop those cab vouchers at my facility - otherwise THESE PEOPLE WILL NEVER LEAVE!!!!! You know, the ones you can triage without really even talking to them? Yeah, they are banned from the facility, but when they show up with a claim of cp, we Have to treat them.
Nov 16, '01Occupation: Clinical Leader Specialty: ER, Hospice, CCU, PCU ; Joined: Jul '01; Posts: 799; Likes: 51I can't count the number of cab vouchers I have given out just to get a specific homo-sapian the heck out of my ER. I wish I could write them to an area where when they call 911 20 minutes later they will be taken to a different hospital........Would that be dumping????? Some just smell so bad you'd do anything to get rid of them
Nov 16, '01Occupation: ED staff nurse From: US ; Joined: Nov '01; Posts: 1,150; Likes: 232Originally posted by fiestynurse
Are you kidding!! Here, unless it is a life or death situation, we get co-pays before we'll even look at them. And we most certainly collect before they leave. Usually a family member is available to help out.
It's a COBRA violation to ask for money BEFORE you render treatment, you cannot even ask the patient to sign a promisory note before they are treated... you could turn your hospital in and make some major bucks, but whistleblowers are frowned upon, though protected by law from being fired. You could point this out to them and score some points for yourself
Nov 17, '01Joined: Oct '00; Posts: 8,729; Likes: 8,412Is anyone willing to share the difference in how much money they were able to collect after starting copays, or by mentioning the outstanding balance at each er visit?
Or is anyone willing to post or email me the name/address of their hospital so I can contact them directly. Of course I will not mention where I got the info if you wish to protect your identity.
I think this is an excellent idea, but would like some numbers to approach admin with.
Email me at canoehead
Thanks, this would be much appreciated.
Nov 17, '01Occupation: RN - Administrative Director Joined: Jun '01; Posts: 9; Likes: 8One of my business professors used to talk about a phenomenon he called the "prostitute syndrome" - the value of the service diminishes after the service has been rendered. I have no problem with our registration folk collecting co-pays and any money they can get as quickly after the service is rendered as is humanly possible. " The best thing a business can do for it's employees is make a profit" Jack Welch