RN's collecting copays

[michelleil]

I work in a major university hospital and my direct supervisor who is also a nurse, is now asking us, the RN's to collect copays. The background is the clinic is just me and the doctor. It is a once a month off campus clinic. I do everything there, check the patient in (however I do not update the insurance or have anything to do with billing), room, vital, update med list, check the patient out (give orders for tests, schedule tests, make their next appt). This is a very busy day for me, but Ive been doing the job for a few years and have gotten the hang of it. Now however, she is asking me the RN to collect the copays. She calls the patient and tells them to bring in the money exact cash or check and I collect it. I told her that this doesn't feel like a nursing responsibility but she said it is. When i told her I felt like it was just one more thing I was being asked to do she said "Puhleeze". My job is an RN coordinator. I work with 1:1 with a speciality doctor and I follow her patients very closely. I give out my number and they call me directly with any problems or issues. I work with them to get patient assistance for their meds, I make sure their tests are completed, and I get to know them personally. For example, one of the patients I am being asked to collect a less then 5 dollar public aid copay on is a refugee who her first visit showed up in sandals in 30 degree weather. I feel like this is ethically not right, given that my job is to create a relationship with these patients to make sure they are getting the best care, and then im asking for money? I do not know what to do? Is this right? Or am i making a big deal over nothing?

[CrunchRN, ADN, RN]

Essentially, you are the receptionist and nurse so not unreasonable. However, I would wonder what you are supposed to do if they don't have it. That could get very difficult ethically and practically.

[tyvin, BSN, RN]

What is so untoward? Someone has to collect it. You work in the clinic period. You can't put your ethical bias before the business, unless it's your business (you own it). Healthcare is a business. You can always quit and start your own free clinic.

Sound like you are getting to personally involved with the patients. Whose idea was it to give out your personal number?

[roser13, ASN, RN]

I would have a HUGE objection to collecting $$ from patients. It is a point of pride that I am able to convey to my patients that I don't deal with the money/insurance/payment issues. I am only all about their health care.

[roser13, ASN, RN]

What is so untoward? Someone has to collect it. You work in the clinic period. You can't put your ethical bias before the business, unless it's your business (you own it). Healthcare is a business. You can always quit and start your own free clinic.

Sound like you are getting to personally involved with the patients. Whose idea was it to give out your personal number?

It is untoward because nurses deal with patient advocacy and patient care. We are not trained to, nor is it compatible with health care delivery, to demand money from our patients.

[michelleil]

oh, No we dont give out our personal numbers. We give out our direct desk numbers. The patients dont go thru a secretary to get to us. Im a care coordinator. I follow these patients for years. Believe me i try not to get too involved, but its part of the job. I have to help them get our expensive medications when they cannot afford them. You meet their family members who come to the appointments, who call you for information when their admitted. I know who was just diagnosed with cancer, whose going to be told they have cancer, and whose not going to live much longer. The secretary doesnt know that. Thats why i dont think it should be asked of me to collect the copay. Im not saying copays shouldnt be collected, by all means its a business and pays my salary. But i dont think a caregiver should have that role. I think it should be a secretary or an MA. But not the patients RN.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I would have a HUGE objection to collecting $$ from patients. It is a point of pride that I am able to convey to my patients that I don't deal with the money/insurance/payment issues. I am only all about their health care.

Ditto! The doctor is not hiring a real receptionist because the OP accepts all the tasks placed upon her. If she puts her foot down, only lifting it to move closer to the front door, the doctor will stop taking advantage...especially if it begins to look like she'll have to do all that crap herself until she finds and trains a replacement.

[LovingLife123]

I would not either. She needs to hire an MA if she wants that done. But then of course an MA can't do what you do. So she's getting her cake and eating it too.

We are not trained in insurance and money issues when it comes to billing. I would research and see if it was at all mentioned in the scope of practice in your state. It may very well be an ethical issue.

[RNOTODAY, BSN, RN]

Yes, you work the front , correct? So , what do you suggest, the doc hire someone to just COLLECT COPAYs???? So yeah, I don't see the big deal , seeing what you do allready

[RNOTODAY, BSN, RN]

But, she's not asking to code / bill... just take the pre determined copay , right? I'm not seeing the big deal... I'm not being snarky, please don't take me that way

[RNOTODAY, BSN, RN]

I would not either. She needs to hire an MA if she wants that done. But then of course an MA can't do what you do. So she's getting her cake and eating it too.

We are not trained in insurance and money issues when it comes to billing. I would research and see if it was at all mentioned in the scope of practice in your state. It may very well be an ethical issue.

But she's NOT billing insurance/ and or coding .... that's a whole other ball game , I wouldn't either , but simply collect a predetermined copay , since she's at the front desk , anyway ?? Plus, she lists all that she does now, including scheduling tests , etc... that's not TYPICALLY a RN role either , but if there's only HER up front ? Who else would take the copay ?? Sounds like the University needs to hire that doc a MA....

[RNOTODAY, BSN, RN]

I would not either. She needs to hire an MA if she wants that done. But then of course an MA can't do what you do. So she's getting her cake and eating it too.

We are not trained in insurance and money issues when it comes to billing. I would research and see if it was at all mentioned in the scope of practice in your state. It may very well be an ethical issue.

But, again , she's not billing / coding... that's a whole other thing... she's just collecting the predetermined copay, she's up front, she coordinated testing , I just don't see the stretch.. I will admit that , the university needs to get the doc an MA