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FINANCIAL ASSISTANCE: maury regional medical GROUP


maury regional medical grOUP FINANCIAL ASSISTANCE POLICY

Maury Regional Medical Group (MRMG) depends on efficient conversion of accounts receivable to cash to meet daily operating needs. This policy is established for the convenience of all patients and the benefit of all families in our service area. Throughout this policy the word "patient" will represent the patient or legal guarantor. Keeping this in mind, the following principles guide our payment policies:

  1. Although MRMG will enter into contract with insurance companies to assist the patients and facilitate the payment of their bills, the patient is legally responsible for his/her bill until it is completely settled by the third party, by the patient, or a combination thereof.
  2. It is emphasized that the patient has the primary responsibility for his/her bill until it is settled. In any controversy, default, or misrepresentation, MRMG will look to the patient for payment. Further, third party coverage does not relieve the patient from his/her responsibility until the account has been paid in full.

Procedure

Insurance Participation:

  1. MRMG Physicians participates with most major insurance plans. (Listings of current provider participation status are available for insurance plans.)
  2. Office staff is responsible for accurately obtaining and scanning picture ID and insurance card for all patients prior to patients receiving care.
  3. If our providers are not "In Network" with any particular plan or if the patient has no insurance, staff must notify patients of their financial responsibility prior to the visit as outlined in this policy.

Scheduling and Registration:

  1. When patients call to schedule appointments, staff is expected to obtain demographic and insurance information.
  2. If patients do not have insurance, staff should inform the patient of payment options. Also, staff should communicate any outstanding balance to patients, and explain the requirement to pay this debt prior to the patient's visit.
  3. During registration, patients should be given a copy of the Financial Policy statement for review and signature.
  4. Staff must ensure that identification and insurance information is correctly entered into the system and copies of identification, insurance cards, and other signed paperwork are properly scanned into the practice management system.

Required Paperwork:

  1. The patient should be given the following forms for review and signature to be scanned into the practice management system:
  1. Financial Policy Statement
  2. Intake form / Medical History
  3. HIPAA Policy
  4. Patient Demographics

Patient Responsibility:

  1. Without exception, it is the responsibility of the patient to pay his/her financial responsibility at time of service. This may include co-payment, outstanding balances, estimated total, upfront deposit and any unpaid portion of the deductible at the time of service. (Services that are clinically deemed non-emergent may be rescheduled due to non-payment of patient balances at the time of service.)
  2. Staff is expected to collect co-pays for all patients with insurance prior to the patient being seen by the provider. Additionally, staff is expected to ask patients how they will be paying for their bill at time of service.
  3. If patients cannot pay for services, staff should offer our payment plan as an option. Patients are discouraged from carrying a balance from one visit to the next.
  4. For surgical patients, staff should communicate to patients that surgery deposits are expected to be paid at your pre-operative visit, or 5 days prior to the date of the surgery or else the appointment will be rescheduled.

Uninsured Patients:

  1. Patients without insurance or who may have financial hardship may qualify for financial assistance. Staff should determine the patients' ability to pay, and if they indicate inability to pay, staff should offer information about financial assistance. (Financial Aid Paperwork and payment plans).
  2. Uninsured patients are expected to pay an upfront deposit of $50 for primary care visits and $100 for specialty care visits.
  3. Additionally, uninsured patients will be given a self-pay discount on the services rendered. The self-pay discount is 48% of our current charges.

Charity Care:

  1. Any patient who demonstrates financial need should be made aware of the Charity Care policy. If patients qualify for Charity Care through MRMG, they are responsible for paying any remaining portion at the time of service. Patients of MRMG who are uninsured, underinsured, ineligible for any government health care benefit program, and who are unable to pay for their care, based upon a determination of financial need in accordance with this Policy. The granting of charity shall be based on an individualized determination of financial need, and shall not take into account, age, gender, race, social status, sexual orientation, or religious affiliation. Financial need will be determined in accordance with procedures that involve an individual assessment of financial need; and may 1. Include an application process, in which the patient or guarantors are required to cooperate and supply personal, financial, and other information and documentation relevant to making a determination of financial need; 2. Include the use of external publicly available data sources that provide information on a patient’s or a guarantor’s ability to pay (such as credit reports); 3. Include reasonable efforts by MRMG to ensure all appropriate payment from assigned insurance carriers or other responsible parties prior to billing the patient; 4. Take into account the patient's available assets.

Payment Options:

  1. MRMG accepts a variety of payment options including Mastercard, Visa, Discover, American Express, personal checks, cashier checks, money orders, and cash.
  2. All returned checks will be assessed a $35 returned check fee in addition to the original charge.
  3. Staff should communicate to patients that all outstanding balances must be paid in full prior to additional office visits.
  4. Patients will be given a 10% prompt payment discount if payment is made in full prior to the service.

Payment Plans:

  1. MRMG offers payment plans for all patients with outstanding balances over $100 (refer to the Payment Plan Guidelines for additional details). If patients have an outstanding balance and cannot make payment and refuse to agree to a payment plan, the patient will not be seen until payment arrangements have been made.

Payment Follow-up / Collections:

  1. Patients will be sent three patient statements reporting any outstanding balances.
  2. Any balance that exists greater than 30 days beyond the third statement without payment will be outsourced to a collection agency for collections.
  3. Once handed over to collections, patients have thirty days to set-up payment arrangements with the collection agency or to make payment in full in order to avoid being reported to the credit bureaus.
  4. Payment files and outsourced accounts are to be completed and transferred to the collection agency weekly.

Financial Assistance Application
To complete an application for financial assistance, click here.

En español:
Para ver una completa Política de Asistencia Financiera MRMC en español, haga clic aquí.
Para completar una solicitud de ayuda financiera en español, haga clic aquí.