Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95

Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

DISCOUNTS AND DEDUCTIBLES

Melanie Posted Fri 26th of March, 2010 11:10:44 AM

I could have sworn that there was verbiage somewhere that indicated we cannot discount the deductible balance that a patient owes .... I was going blind last night at home searching for something to this topic...

Any thoughts?

SuperCoder Answered Fri 26th of March, 2010 14:12:28 PM

As per this document: http://www.healthandwelfare.idaho.gov/Portals/0/Health/Rural%20Health/DiscountedFeeSchedule.pdf

-- it says: "A routine waiver of Medicare coinsurance and deductibles can violate the Federal anti-kickback statue –if one purpose of the waiver is to generate business payable by a Federal health care program. There are twoimportant exceptionsto the general prohibition against waiving Medicare coinsurance and deductibles 1) financial hardship and 2) inpatient hospital services."

Medicare cost-sharing amounts may be waived so long as:

1) The waiver is not offered as part of any advertisement or solicitation;
2) The provider does not routinely waive coinsurance or deductible amounts; and
3) The coinsurance and deductible amounts are waived after determining in good faith that the individual is in financial need or reasonable collection efforts have failed.

Related Topics