Insurance and Billing Process: It is the patient’s responsibility to confirm insurance benefits with their insurance plan(s) before visiting a healthcare provider. The patient must provide or confirm their name, date of birth, address, and current insurance plan information (collectively, Demographics) each time they visit a healthcare provider. Failure to confirm, update, or present current Demographics at check-in may result in billing delays and errors. Errors of this nature can result in insurance failing to cover its portion of the patient’s care, increased patient responsibility, or referral to a collection agency.
Pre-Authorization and Certification: If the patient’s insurance plan(s) require pre-authorization or certification, the patient is responsible for calling the healthcare provider’s business office before being seen. The healthcare provider will assist the patient in obtaining any pre-authorizations or certifications. Failure to obtain prior authorization or certification may result in the patient being held responsible for their cost of care.
Financial Assistance: Hospital Pathology Associates (HPA) is committed to providing the highest-caliber pathology services regardless of one’s financial status. The healthcare provider admitting the patient for care has applications for financial assistance that can be applied for before or after a clinical visit or hospitalization. HPA does not admit or see patients. Due to this fact, HPA is referred to as “nonpatient-facing” and honors any financial assistance granted by its healthcare providers. In addition, the options for financial assistance related to HPA’s services can be obtained by contacting its administrative office at 612-767-8370.
Claims Submission: HPA receives patients’ Demographics from the healthcare provider. HPA will submit a claim(s) to the patient’s insurance plan(s) and assist the patient in getting the claim paid by the insurer. However, it is the patient’s responsibility to provide any insurance coverage directly to its healthcare provider or HPA’s billing department if it is not indicated on their Explanation of Benefits (EOB) or billing statement.
Billing: HPA will bill the patient’s insurance directly based on the Demographic information received from the healthcare provider. Once the patient’s insurance plan processes the claim(s), a text link to the HPA payment port and a statement will be sent to the patient’s billing address for any deductible, co-payment, or co-insurance on any remaining balance not paid by insurance. In cases where a patient notifies HPA of a billing error or omission, HPA will place the balance due on hold, investigate, and correct the error. Following correction, HPA will refund or rebill the patient with the correct amount due within 30 days of correcting an error or omission.
Payment: Payment in full is due upon receipt of the patient’s statement. HPA accepts payment by credit card, personal check, or money order. Payment can be made at www.personapay.com/ahhpap/login or by mailing a check or money order with the top portion of the patient’s statement to the address on the statement. If the patient cannot pay their balance in full, it is their responsibility to contact our billing department at (612)-248-1657 to establish a mutually agreeable, interest-free payment plan. A patient failing to pay their balance in full or comply with their payment plan arrangement may result in their account being forwarded to a collection agency.
Collections: An independent, third-party debt collection agency may be employed only after reasonable collection and payment options have been exhausted. Patients who are delinquent or uncooperative in making payments, have not followed a payment plan, or are unwilling to provide reasonable evidence of hardship may be sent to a collection agency to help resolve their accounts. When reviewing a patient account for referral to a collection agency, the billing department will verify that the patient is believed to owe the debt, all known payers were properly billed, any remaining debt is the responsibility of the patient, and the patient was provided a reasonable opportunity to arrange a payment plan or seek financial assistance. Collection agency staff will uphold the confidentiality and individual dignity of the patient and will comply with all HIPAA requirements for handling Protected Health Information (PHI).
Enforcement: Through the adoption of this policy, HPA will enforce this policy for all billing staff and collection agencies. Any abusive, harassing, misleading language or inappropriate conduct by its billing or a collection agency’s staff responsible for collecting medical debt will be addressed through a corrective action procedure.
Equal Opportunity: HPA is committed to upholding federal and state laws applicable to decisions made throughout the payment and collection process pertaining to discrimination based on race, religion, sex, age, sexual orientation, disabilities, marital status, military service, or any other classification protected by federal, state, and local laws.
Confidentiality: HPA will uphold its patient’s dignity and the confidentiality of their PHI. HPA will meet all HIPAA requirements for the handling of PHI.