Billing & Collection Policy

Subject to compliance with the provisions of this policy, RMC may take any and all legal actions, including Extraordinary Collection Actions, to obtain payment for medical services provided.

RMC will not engage in ECAs, either directly or by any debt collection agency or other party to which the hospital has referred the patient’s debt, before reasonable efforts are made to determine whether a Responsible Individual(s) is eligible for assistance under the FAP.

All patients receiving hospital inpatient and outpatient services will be offered a Plain Language Summary for financial assistance under the FAP as part of the discharge or intake process from a hospital. Note: Offering this summary notice for patients receiving services at Regional Family Health or Regional Home Care and Hospice is not required.

At least five separate statements for collection of Self-Pay Accounts shall be mailed to the last known address of each Responsible Individual(s) provided, however, that no additional statements need to be sent after a Responsible Individual(s) submits a complete application for financial assistance under the FAP or has paid-in-full. At least 60 days shall have elapsed between the first and last of the required three mailings. It is the Responsible Individual(s) obligation to provide a correct mailing address at the time of service or upon moving. If an account does not have a valid address, the determination for “Reasonable Effort” will have been made. All Single Patient Account statements of Self-Pay Accounts will include but not limited to:

• An accurate summary of the hospital services covered by the statement;
• The charges for such services;
• The amount required to be paid by the Responsible Individual(s) (or, if such amount is not known, a good faith estimate of such amount as the date of the initial statement); and
• A conspicuous written notice that notifies and informs the Responsible Individual(s) about the availability of Financial Assistance. The notice will include the telephone number of the department and direct website address where copies of documents may be obtained.

At least one of the statements mailed will include written notice that informs the Responsible Individual(s) about the ECAs that are intended to be taken if the Responsible Individual(s) does not apply for financial assistance under the FAP or pay the amount due by the Billing Deadline. Such statement must be provided to the Responsible Individual(s) at least 30 days before the deadline specified in the statement. If is the Responsible Individual(s) obligation to provide a correct mailing address at the time of service or upon moving. If an account does not have a valid address, the determination for “Reasonable Effort” will have been made. RMC does utilize Redsson to attempt to obtain a valid patient address.

ECAs may be commenced as follows:

• If any Responsible Individual(s) fail to apply for financial assistance under the FAP by 120 days after the first post discharge statement, and the Responsible Parties have received a statement with a Billing Deadline described, then RMC or collection agency may initiate ECAs.
• If any Responsible Individual(s) submits an incomplete application for financial assistance under the FAP prior to the Application Deadline, then ECAs may not be initiated until after each of the following steps has been completed:
  – RMC provides the Responsible Individual(s) with a written notice that describes the additional information or documentation required under the FAP in order to complete the application for financial assistance, which notice will include a copy of the Plain Language Summary.
  – RMC provides the Responsible Individual(s) with at least 30 days’ prior written notice of the ECAs that RMC or collection agency may initiate against the Responsible Individual(s) if the FAP application is not completed or payment is not made; provided, however, that the Completion Deadline for payment may not be set prior to 120 days after the first post discharge statement.
  – If the Responsible Individual(s) who has submitted the incomplete application completes the application for financial assistance, and RMC determines definitively that the Responsible Individual(s) is ineligible for any financial assistance under the FAP, RMC will inform the Responsible Individual(s) in writing the denial and include a 30 days’ prior written notice of the ECAs that RMC or collection agency may initiate against the Responsible Individual(s) provided, however, that the Billing Deadline may not be set prior to 120 days after the first post discharge statement.
  – If the Responsible Individual(s) who has submitted the incomplete application fails to complete the application by the Completion Deadline set in the notice, then ECAs may be initiated.
  – If an application, complete or incomplete, for financial assistance under the FAP is submitted by a Responsible Individual(s), at any time prior to the Application Deadline, RMC will suspend ECAs while such financial assistance application is pending.

After the commencement of ECAs is permitted, collection agencies shall be authorized to report unpaid accounts to credit agencies, and to file judicial or legal action, garnishment, obtain judgment liens and execute upon such judgment liens using lawful means of collection; provided, however, that prior approval of RMC shall be required before initial lawsuits may be initiated. RMC and external collection agencies may also take any and all legal other actions including but not limited to telephone calls, emails, text, mailing notices and skip tracing to obtain payment for medical services provided.