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Payment Expectations Policy

It is the policy of Scottsdale Lincoln Health Network to collect on patient liability amounts on or before the date of service, where possible. This policy is effective for hospital discharge dates on or after May 1, 2014 and may be used in conjunction with the Financial Assistance policy.

This policy is designed to provide consistency in collection of financial responsibility for all patients, outline the responsibility for collecting payment and providing discount information at the time of service, and to establish protocol for denial of non-emergent services when copayments and coinsurance are not paid at the time of service.

Except as otherwise provided by law, the Guarantor (patient or responsible party), is financially responsible for services provided by Scottsdale Lincoln Health Network. The hospital may verify the patient's address and ability to pay by utilizing credit reporting or other available data.

General Payment Expectations

  1. If the patient has health insurance, we will expect the patient/guarantor to pay their patient liability at the time of service.
  2. For emergency services, we will expect the patient/guarantor to pay the amount due, or a deposit toward their liability after the medical screening exam is completed.
  3. If the patient's insurance company has not paid Scottsdale Lincoln Health Network within 60 days of the time we bill the insurance company, we will expect payment from the patient. Formal payment arrangements can be set up to extend the payment time frame, within the Network's policy.
  4. If the account is referred to an independent agency for collection, the patient/guarantor will be responsible to pay reasonable collection expenses, including court costs, credit verification expenses, and attorney fees.
  5. If the patient/guarantor is unable to pay the hospital bill, or cannot make formal payment arrangements, notify hospital personnel immediately, in order to initiate time-sensitive applications for state, federal, or hospital programs.
  6. Discounts of any type will not apply where the Hospital has lien rights pursuant to A.R.S. Sections 33-931 through 33-934. The Hospital will collect lien funds from the settlement.

Uninsured Patients

  1. Emergent/Non-Scheduled Services:
    • Collection attempt will be made for a deposit on the account, after medical screening exam is completed.
    • Patient is eligible for a 50% prompt pay discount if paid in full within 60 days of discharge.
    • Patient is eligible for a 35% direct pay discount if unable to pay within 60 days and payment arrangements are made.
    • If a package rate is available for the service, payment is required at time of service.
  2. Scheduled Medical Services:
    • Patient is eligible for a 50% prompt pay discount if paid in full prior to or at the time of discharge.
    • If the patient/guarantor is unable to pay the total amount due prior to or on the date of service, they must pay 50% of the applicable prompt pay discounted price, or have approval from the VP or Director within the Revenue Cycle.
    • Patients may be evaluated for financial assistance through referral to the charity committee as necessary.
    • Additional charges, changes to procedures, or O.R. time which result in additional charges to the patient after their date of service will be discounted accordingly.

Insured Patients

  1. Emergent/Non-Scheduled Services:
    • Patient liability may be calculated using a bill estimator or information obtained from the payer representative, and may be requested after the medical screening.
    • Medicare: The patient share is not eligible for a discount because the reimbursement for services is determined by the program and is apportioned between the Medicare payment and the beneficiary deductible and co-insurance amounts. Medicare expects the beneficiary to pay their share in full and the provider is expected to be in compliance.
    • Contracted Plans: The patient share is not eligible for a discount because the contracted amount is apportioned between the insurance and the patient. The charges are already discounted, and no further reduction is available.
    • Non-Covered Services are eligible for a discount consistent with the discounts provided to uninsured patients.
  2. Scheduled Medical Services:
    • Patient liability is calculated using a bill estimator or information obtained from payer representative.
    • Collection attempts on patient deposit amounts, including deductible, copay, and co-insurance amounts will be made on or before the date of service, when practical. Patients may request to be billed after the insurance company has paid the claim and determined their liability.
    • Patients with large deductible plans are required to pay up to 50% of the remaining deductible amount, or the estimated patient liability, whichever is less. A PFS Director or Patient Access Director approval is required if amount due is more than $10,000 and the patient is unable to pay the requested amount at the time of service.
  3. Package Procedures:
    • Packaged services are discounted from total charges in advance, and therefore excluded from discounts. The package price amounts are due on or before discharge from facility.
    • Packaged services include but may not be limited to:
      • Labor and Delivery
      • Cosmetic Services
      • Rehabilitation Services
      • Adult Fitness
      • Nutrition Consult
      • Some surgical services (ex: bariatric, joint surgery)