Is it illegal for medical practioners to waive copay

[vikasintl]

WA state

Is it illegal for medical practitioners to waive coinsurance/ copay ?

I think in some circumstances they can waive patients' coinsurance / copay ..may I know in what circumstances they can waive this legally?

 

[ecmst12]

In most cases it is frowned upon by insurance companies, they need to at least make an attempt to collect it. If the provider has a hardship program, and the patient applies for it and is approved, they may be able to waive the copay without issues.

 

[lealea1005]

WA state

Is it illegal for medical practitioners to waive coinsurance/ copay ?

I think in some circumstances they can waive patients' coinsurance / copay ..may I know in what circumstances they can waive this legally?

Government insurance like Medicare & Medicad require Physcians to attempt collections of co-pays/co-insurances/deductibles. The Physician must be able to prove s/he attempted collections.

Other insurance companes may contracturally obligate their providers to attempt collection of co-pays/co-insurances/deductibles.

 

[vikasintl]

so attempt is enough??

So as long as they can show they tried like one or two phone calls and a mail letter...its enough correct?
or what kind of attempt they should have made?

 

[tranquility]

What is your real question? What happened?

 

[lealea1005]

So as long as they can show they tried like one or two phone calls and a mail letter...its enough correct?
or what kind of attempt they should have made?

Normally, a provide sends a bill because they expect to be paid for their services.

Please answer tranquility's question.

 

[ecmst12]

Are you the provider doing the billing or are you the patient? If you are the patient, you should not be expecting your doctor to give up on collecting your copays - they can and very likely will pursue collections all the way up to a lawsuit. If you are in need of financial assistance, you need to see if you can work something out with the office, if they're willing, otherwise you need to find a way to pay the balance or the office may very well stop treating you.

 

[xylene]

If a doctor wants to eat your copay, that is totally legal.

 

[vikasintl]

I asked provider before visit about waiving copay...

What is your real question? What happened?

I asked one of the providers if you can waive copay as copay only will be about $800 ...but the provider office said its illegal...so I was wondering if this is their excuse or they are real?

 

[cbg]

There's no way on earth a copay is $800. Are you sure you don't mean coinsurance?

 

[vikasintl]

yeah I meant coinsurance and not copay

There's no way on earth a copay is $800. Are you sure you don't mean coinsurance?

sorry yeah I meant coinsurance...

 

[lealea1005]

I asked one of the providers if you can waive copay as copay only will be about $800 ...but the provider office said its illegal...so I was wondering if this is their excuse or they are real?

"only will be about $800"...you're kidding, right? I'm sure you like to be paid for your work...well, so do Physicians (and other providers).

Quote by:xylene
If a doctor wants to eat your copay, that is totally legal.

As I said earlier...not with Medicare or Medicaid.... and most private insurance contracts require provable collection attempts.

 

[Ohiogal]

sorry yeah I meant coinsurance...

Do you work for free? Or should I guess that you get through life without working and take every benefit known because you are "owed" that?

 

[cbg]

Waiving a copay and waiving a coinsurance are two entirely different things.

Completely setting aside the issue of legality, it's one thing to waive a $15 copay. It's entirely another to waive an $800 coinsurance. What makes you think that's such a small amount? The doctor has bills to pay too; they're not all rich.

 

[ecmst12]

Well for your purposes it doesn't matter whether it's an excuse or the truth, they're not going to waive your coinsurance. Set up a payment plan.