BILLING & COLLECTIONS

Today’s health care billing and collections system can be confusing and complex. Everyone involved in health care—from providers to patients to state and federal government—must work together and share responsibility to fix it.

Ohio hospitals are committed to a charitable mission of providing quality health care 24 hours a day, seven days a week to everyone in their community regardless of their ability to pay. But hospitals cannot keep their doors open without adequate reimbursement for their services.

In 2004, Ohio hospitals provided more than one billion dollars worth of charity and other uncompensated care to uninsured and medically indigent patients, including those on Medicaid and Medicare.

BILLINGS AND COLLECTION NEWS

4/29/2008:: CMS has released a revised Advance Beneficiary Notice (ABN) for providers to give patients in all instances where Medicare payment is expected to be denied. The revised ABN replaces the existing ABN-G, ABN-L, and the Notice of Exclusion from Medicare Benefits (NEMB). CMS will allow a 6-month transition period. English and Spanish copies of the revised ABN, instructions and frequently-asked questions are available on the CMS Beneficiary Notice Initiative Web site.

2/12/2008:: OHA has reached an agreement between HTP Inc and OHA Solutions to create a new model for revenue cycle management that helps hospitals initiate patient financial planning assistance for the insured, uninsured, and underinsured resulting in lower bad debt, better patient charity care qualification and maximize and increased net revenue. OHA Solutions sent an e-mail to hospital CFOs this week with additional information. View a related news release

2/04/2008:: The Ohio Department of Health (ODH) announced an increase in the maximum amounts providers can charge during 2008 for providing copies of medical records. Using the formula required by Ohio statute, ODH increased the maximum fees by 2.8 percent. Hospitals may charge $2.74 for each of the first 10 pages, 57 cents for pages 11 through 50, and 23 cents per page above 50 pages, if the request is made by the patient or a patient's personal representative, and if the request is for data on paper. The fee for data recorded other than on paper is $1.87. Fees are different if the request is made by someone other than the patient or the patient's personal representative.  View the ODH posting, and the statutes are available at http://codes.ohio.gov/orc/3701.741 and http://codes.ohio.gov/orc/3701.742. 

2/01/2008:: A new edition of the OHA Hospital Law Handbook is now available. The handbook is a compendium of select Ohio statutes and regulations applicable to hospitals, physicians, nurses and other health care workers. The new edition consists of more than 900 pages, organized into 11 chapters, with the approximately 950 statutes and regulations current to Jan. 1, 2008. OHA will identify changes to the handbook through postings on the OHA web site. The cost is $100 for OHA members and $150 for nonmembers. View ordering information.

1/23/2008:: The 2008 federal poverty income guidelines were published in the federal register today. Updated annually by the US Dept. of Health & Human Services, the guidelines are used in a variety of ways to judge eligibility for discounted health care programs, including the Ohio Hospital Care Assurance Program.