Discharging Patients for Not Paying

So what do you do when patients are not paying?  If you have an automatic withdrawal, and you should, then maybe their card has expired or they canceled their card due to security compromises.  The best way to figure this out is to email and/or call them.  But some patients are just not going to pay so then wait?

  1. Are we obligated to give 30 days of emergency care (as in FFS) until they find a new PCP? I know this may vary by state. What are you all doing in this case?
  2. Every time this issue came up at the Summit, they indicated the 30 days was kind of a necessity. To my knowledge, the only exception to that is if the doctor or staff was physically threatened, etc.
  3. I spoke to a Med-mal defense attorney once who said that providing “emergency care” can include recommending a patient go to an urgent care or ER if you deem their situation necessary for attention, and you are unable to see them in a timely manner.
  4. And my understanding is that if you get a medical release from them because they are transferring care, you have no obligation to do anything for them, other than forward records, from the moment you open the envelope.
  5. Right that would make sense. So if they leave, done. If we discharge, then 30 days. Can we add a statement to patient agreement that if they call text email within that 30 days, they will be charged a fee? Just kidding, we’ll not really, had a guy text me 3 times after he cancelled within that 30 days about an issue that was not appropriate to dump to urgent care or ER. Anyone have this happen?
  6. Yes, but rare. I usually just tell them that if they are concerned, they should go to urgent care to have it looked at, and they will pay more for that 15 minutes with a PA (after a 2 hour wait) than they would for several months of care in my office.
  7.  And remember we’re not emergency doctors so the irony of 30 days emergency care is we don’t provide emergency care … We can be responsible to make sure they do if they need it but — I also think somewhere I found that failure to pay is grounds for termination. You do have to show that you made a reasonable time to help them pay but Why not pick a one or two month mark and send the 30 day emergency care notice along with saying how you would be happy to help them discuss options to get caught up on payments in that interval…. Only the shameless continue to come in after that and then at least you know you should never let them back into your practice.