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Is  your clinic routinely forgiving deductibles and copays? If so, you may want to rethink it.

The AMA’s Code of Medical Ethics Opinion 6.12 explains why routine waivers are unethical, particularly when a clinic advertises a willingness to waive copayments. Further, the Office of Inspector General (OIG) has long taken the position that routine waiver of copayments constitutes an illegal kickback, which is a felony.

According to Physician’s Practice, http://www.physicianspractice.com/blog/medical-practices-think-twice-before-waiving-copays, the routine waiver of copayments also constitutes a violation of the terms of private insurance company plans. This contractual violation serves as a basis for a recoupment audit, during which insurance companies request proof of collection of copayments for five randomly selected patients. If the clinic cannot prove it collected, or at least exhausted all reasonable means of collection, then the carrier may demand a refund for any benefits paid across a large patient population.

You can review the entire article at http://www.physicianspractice.com/blog/medical-practices-think-twice-before-waiving-copays

Courtesy of  The American Medical Billing Association, Daily Buzz, 11.18.13