Billing & Collection: When allowed by contract or regulatory statute, SBMC will send regular summary patient statements and detail itemized statements when requested by the patient or responsible party. Any attorney request for billing statements will be fulfilled by sending detail itemized statements when proper patient or legal authorization is provided.
SBMC sends a letter to all Commercial, Managed Care, and Medicare patients 2 days after final bill to verify insurance coverage. A request is made to the patient at that time to contact the Business Office with any corrections or additions to their current insurance coverage. Once the primary insurance plan has paid and amounts due from the patient/guarantor are determined, the accounts begin the billing cycle described below for self-pay patients/guarantors.
SBMC billing cycles for sending self-pay patient/guarantor statements are as stated below:
Statement cycle commences at discharge
First bill is produced with Financial Assistance Summary (FAS) included on second page of bill. It is the obligation of the patient/guarantor to provide a correct mailing address at the time of service or upon moving.
Successive statements sent at a minimum of 21 days, but not greater than 30 days
After 90 day period has lapsed, a notification letter is sent stating a deadline that is no earlier than 30 days after the date that the written notice is provided at which time the account will be assigned to collection agency and reported as a negative item with a credit bureau.
After 120 day notification period, SBMC Business Office Director or assigned manager will review accounts to ensure all reasonable efforts to determine FAP eligibility have been made and approve accounts prior to assigning to a collection agency.
SBMC will accept and process Financial Assistance Applications from an individual that has not previously been determined whether FAP eligible from day 121 to day 240 from first post discharge statement.
Patients with Medicaid as the primary payer or Medicare patients with Medicaid as secondary payer should not have statements mailed to them.
SBMC and its external collection agencies may also take any and all legal actions including, but not limited to, telephone calls, emails, mailing notices, and skip tracing to obtain payment for medical services provided.
SBMC will make a reasonable effort to orally communicate with the patient/guarantor about its FAP and about how assistance may be obtained with the FAP application process before an account is turned over to a collection agency and reported as a negative item with a credit bureau.
The Financial Assistance Application form is available free of charge on the SBHC website and upon request.
A printed copy of the Financial Assistance Policy is available free of charge on the SBHC website or upon request.
A Financial Assistance Summary is available free of charge on the SBHC website, upon display at the facility, included in the self-pay admission packet, and upon request.
The Hispanic Community Services, Inc (HCSI) and Covenant Medical Benefits have been identified as available sources of assistance with the FAP applications.