Payment for Service Policy

Payment for Service Policy

 

Policy Name: Payment for Service Policy

Policy Version: 1.0

Policy Number: PS-001

 

Business Impact Assessment

 

The Payment for Service Policy is crucial for the financial health of BritMed Healthcare Ltd, ensuring that all services rendered are compensated appropriately. By establishing clear billing procedures and payment expectations, this policy enhances revenue cycle management, reducing the risk of revenue loss due to unpaid invoices or misunderstandings. Moreover, by allowing for flexible payment options and financial assistance programs, BritMed Healthcare Ltd is positioned to serve a broader patient population, thereby increasing patient retention, satisfaction, and ultimately contributing to the organization’s reputation and sustainability.

 

Equality Impact Assessment

 

BritMed Healthcare Ltd has conducted an equality analysis during the review of this policy to ensure that it does not discriminate against any patient based on their financial circumstances. The analysis highlighted the importance of providing financial assistance options, such as a sliding fee scale, to support patients who may struggle to pay for services. By ensuring that financial assistance is communicated effectively and readily accessible, BritMed is dedicated to delivering equitable healthcare services and complying with equality laws.

 

Summary of the Policy

 

The Payment for Service Policy outlines the terms under which BritMed Healthcare Ltd provides and secures payment for its medical services, both onsite and through telemedicine consultations. The policy establishes billing procedures that include issuing invoices to patients, specifying co-pays or coinsurance amounts, and outlining payment expectations such as deadlines and accepted payment methods. Additionally, it includes provisions for financial assistance programs to accommodate patients without adequate insurance coverage. This policy aims to facilitate a smooth payment process while promoting transparency and accessibility in healthcare services.

 

Relevant Legislation

 

– The Health and Social Care Act 2012

– The National Health Service Act 2006

– The Equality Act 2010

– The Consumer Credit Act 1974

– The Data Protection Act 2018 (GDPR)

 

1. Purpose of this Policy

 

The purpose of the Payment for Service Policy is to provide a structured framework for billing and payment processes at BritMed Healthcare Ltd. It aims to establish clear expectations for patients regarding their financial responsibilities associated with medical services and to ensure compliance with applicable laws and regulations. This policy also supports the operational integrity of the healthcare services provided by BritMed by promoting transparency and fairness in billing practices.

 

Furthermore, it seeks to set operational protocols for all staff members, ensuring that procedures comply with legislation, guidance, and best practices while supporting BritMed Healthcare Ltd in fulfilling Key Lines of Enquiry and Quality Statements.

 

Quality Statements Related to this Policy

 

1. a) SAFE Care

Utilizing this policy contributes to Safe Care by ensuring that patients are clearly informed of their payment obligations, which helps to prevent financial disputes that could impact their care experience. By maintaining transparent billing practices, patients can focus on their health without confusion about financial matters.

 

1. b) EFFECTIVE Care

The policy promotes Effective Care by ensuring that patients receive timely invoices, thus fostering proactive communication regarding financial responsibilities. This allows both patients and the organization to allocate resources effectively, thereby facilitating timely access to healthcare services.

 

1. c) RESPONSIVE Care

This policy encourages Responsive Care by providing patients with various payment options and financial assistance programs. By being sensitive to the diverse financial situations of patients, BritMed Healthcare Ltd can better meet their needs and ensure they receive the care they require.

 

1. d) WELL-LED

The Payment for Service Policy demonstrates that BritMed Healthcare Ltd is Well-Led by establishing clear procedures and responsibilities for staff involved in billing and collections. This ensures accountability and promotes a culture of financial transparency that supports patient care.

 

The policy fulfills the standards set by the Care Quality Commission (CQC) by ensuring that financial transactions are clear and fair, ultimately enhancing the patient experience.

 

2. Scope of this Policy

 

1. a) Staff

All staff members involved in the billing and payment processes will be affected by this policy, as it outlines their roles and responsibilities in maintaining financial transparency and compliance. Staff will need to understand the billing procedures to provide accurate information to patients.

 

1. b) Patients

Patients receiving services from BritMed Healthcare Ltd will be impacted by this policy, as it outlines their financial responsibilities concerning payments for services rendered. Transparency in billing will ensure that patients understand their financial commitments and available assistance.

 

1. c) External Health Professionals

External health professionals, including referring practitioners, may be affected by this policy, especially in terms of how they communicate and coordinate care with BritMed Healthcare Ltd. Clear billing procedures can influence external referrals and patient transitions between services.

 

3. Objectives of this Policy

 

– To clarify billing procedures and payment expectations for patients receiving services from BritMed Healthcare Ltd.

– To provide flexible payment options and financial assistance programs to accommodate a diverse patient population.

– To maintain transparency in financial transactions to enhance patient trust and satisfaction.

– To ensure staff members understand their roles and responsibilities in the billing process to promote compliance with relevant regulations.

 

This policy will help BritMed Healthcare Ltd staff clearly understand their roles and responsibilities regarding patient billing and payment processes while ensuring adherence to current laws and best practices. It enhances cooperation between clinical and administrative staff, fostering a unified approach to patient care and financial management. Identification of payment-related risks will also facilitate continuous improvement in the organization’s overall care delivery.

 

4. The Policy

 

Payment Terms Policy

 

Purpose: This policy determines the terms under which BritMed Healthcare Ltd will be compensated for its onsite medical services and telemedicine consultations.

 

Scope: This policy applies to all patients who receive services from BritMed Healthcare Ltd, including both onsite medical services and telemedicine consultations.

 

Terms of Payment:

 

Billing Procedures:

1. A detailed invoice will be mailed to patients after each visit, including a description of services rendered and the co-pay or coinsurance due.
2. Patients are expected to pay the co-pay or coinsurance amount within 30 days from the invoice date.
3. A late fee of £25 will be added to all accounts not paid within 30 days.

 

Payment Methods:

1. Cash: We accept cash payments for all amounts in person at our clinic.
2. Credit/Debit Card: Payments may be made over the telephone, online, or through our secure server payment portal on our website.
3. Insurance: We participate with most major insurance carriers. It is the patient’s responsibility to verify their insurance coverage and any out-of-pocket expenses before receiving services.

 

Financial Assistance:

1. Sliding Fee Scale: BritMed Healthcare Ltd offers a sliding fee scale for patients with inadequate health insurance. Patients are encouraged to call the billing department to discuss payment options and eligibility.
2. Discounts: Discounts are available for full payment at the time of service or for settling current balances.

 

Amendments:

This policy is subject to change at any time without notice. Changes will be communicated to all patients it applies to.

 

Acceptance:

By using the service, patients acknowledge that they have read and understood this policy.

 

For inquiries, please contact:

– Email: [email protected]

– Address: 1-3 Manor Road, Chatham, England, ME4 6AE

 

Key Facts – People Affected by the Policy

 

1. Staff Responsibilities: Staff must understand billing procedures and be prepared to assist patients with inquiries regarding their payments and financial assistance options.
2. Patient Financial Responsibilities: Patients should be aware of their co-pays, coinsurance amounts, and payment deadlines to avoid late fees and ensure timely care.
3. Availability of Assistance: Patients should know financial assistance options, including the sliding fee scale, to support their access to medical services.

 

Outstanding Practice

 

– Transparent Billing Practices: Clear and detailed communication of billing practices to ensure patients understand their financial responsibilities.

– Comprehensive Financial Assistance: Offering flexible payment options and assistance programs to accommodate patients in various financial situations.

– Regular Staff Training: Ongoing training for staff on billing procedures and customer service to enhance patient satisfaction.

– Use of Technology: Utilization of secure online payment portals to facilitate easy and safe transactions for patients.

 

Risks Related to this Policy

 

– Non-Payment by Patients: Risk of uncollected payments leading to financial strain on BritMed Healthcare Ltd.

– Patient Confusion: Lack of clarity regarding billing procedures may lead to misunderstandings and dissatisfaction among patients.

– Inadequate Financial Assistance Awareness: Patients may not be aware of available financial assistance programs, which could deter them from seeking care.

 

Mitigation Strategies

 

– Clear Communication: Ensure all patients receive understandable billing information and reminders about payment deadlines.

– Flexible Payment Plans: Establish payment plans for patients who may struggle to make a lump sum payment, thereby reducing the risk of non-payment.

– Outreach Programs: Actively promote financial assistance options to patients through multiple channels, such as staff interactions and printed materials.

 

The Payment for Service Policy at BritMed Healthcare Ltd is designed to ensure financial transparency, foster trust in the organization, and facilitate access to quality healthcare services. By adhering to this policy, staff can create a supportive environment that encourages patient engagement while ensuring the financial sustainability of the services provided.