If a hospital becomes aware a patient received a payment from a liability insurer, must it pursue the patient for that payment prior to writing the account off to HCAP?
A liability insurer is not a health care third-party payer, so OAC 5101:3-2-07.17 (C) does not require a hospital to pursue a payment from one. However, Section (C)(4) gives a hospital the option to pursue any “compensation or benefits from any person or governmental agency for goods and services rendered.” As such, if the hospital is sure the payment from the liability insurer was directly related to the health care delivered in an account written off to HCAP it has the option to pursue the liability insurance payment it if it wishes. Note this FAQ was moved from Section 2 on Applications.
Related Questions
- If a PatientInsure patient has a Covered Complication that I would have treated myself in my office prior to PatientInsure, should I now send the patient to the hospital?
- If an uninsured patient states his injuries were the result of an accident, must the hospital bill a liability insurer before writing the account off to HCAP?
- What happens if my payment isnt received prior to a training event?
