The American Physical Therapy Association has put together the Top 10 list of changes to be aware of when it comes to Obomacare and federal marketplace insurance plans. Number 8, below, is quite interesting. If my patients CHOOSE to not pay their premiums or my bill, my practice is held accountable and may go unpaid. WOW! I guess I will have to have proof of insurance premium payments from these patients in order to stay afloat!? 8. You may not get paid for up to 2 months of claims if a beneficiary with federally subsidized insurance coverage purchased in the Marketplaces does not pay his or her premiums for 3 months. Specifically, health plans must offer a 3-month grace period to enrollees who receive advance payments for premium tax credit—offered to low-income enrollees in order to reduce out-of-pocket exchange costs—and miss a monthly premium payment. This is intended to enhance continuity of care for those who cannot afford premiums for certain months due to job loss or other financial constraints. Plans are required to pay all claims in the first month of the grace period but can pend claims made in the second and third months, at which point the patient must pay either the claim or their insurance premium. If they cannot afford the payment, then claims during this second and third month can go uncompensated. This is especially important for small practices to be aware of and prepare for as they treat these new patients.
Posted on: Wed, 06 Nov 2013 15:34:07 +0000
Trending Topics
Recently Viewed Topics
© 2015