How Accurate Are Your Healthcare Estimates?

Hopefully fairly accurate, or you may find yourself stuck without payment from a patient. 

We can help your practice get up to date and prepared to minimize breach risks from third-party vendors. Subscribe to stay current and up to date on important matters that will impact your practice.  (To subscribe to our blog ).

Recently, the Colorado Supreme Court found that a patient did not have to pay $230,000 because the price was not disclosed in the hospital service agreements that she signed. 

The patient had received an estimate that her portion of a spinal fusion surgery would be approximately $1,300 after insurance. 

However, she received a bill for $230,000 after the hospital later determined she was actually out-of-network. 

She didn’t pay and the hospital sued her for breach of contract. 

The court found that the price was left open in the agreements so a ‘reasonable value rule’ would apply. In total, the patient paid $1,766. 

There are many things that can be gleaned from this particular case. 

First and foremost, it is essential to check insurance properly. 

With Surprise Billing, it is also incredibly important that Good Faith Estimates provided by your practice are as accurate as possible. 

While state laws may differ, pursuant to federal law, it is important to make sure your final bill to a patient is within $400 of your estimate. Even then, make sure to have your unforeseen reasons for the overage documented. 

If you need help with your estimates, billing, or audits, contact Rickard & Associates today!

We know you’re busy. Subscribe to our blog to get updates and news sent directly to your inbox!

We publish vital information on health law topics and news every Wednesday and Friday. To get this important information delivered directly to your mail box, subscribe today!

Do you need help with updating your Business Associate Agreement or negotiating contracts with third-party vendors?  We can help. To contact us about your Business Associate Agreement, your vendor contracts or your other legal needs, call us today.

Related Posts

Categories

Recent Posts

Who Pays Attorney Fees?
June 30, 2022
Does Facebook have your PHI?
June 28, 2022
How to Protect Your Business from Cybercrime
June 23, 2022
Are You Continuing to Offer Telehealth?
June 21, 2022
Employee or Independent Contractor?
June 16, 2022

Subscribe

Enter your email to subscribe now and receive your FREE HIPAA Risk Assessment book!

An essential tool for all healthcare providers, Easy Guide to HIPAA Risk Assessments breaks down the requirements of HIPAA so you can successfully complete your required risk assessment.

 

Get it now for FREE (an $8.99 value!)

One more step! Please check your email to confirm your subscription and receive your FREE book!