Debt Collection Procedure

Billing & Collection Policy

Policy Statement
It is the policy of the Center for Restorative Surgery at Maple Grove to collect patient balances within 60 days of sending the first statement.

Procedure

• Patient Billing
  • It is the goal of the Center for Restorative Surgery at Maple Grove to bill insurance claims as appropriate and on a timely basis. The timeliness of billing and claims processing is dependent on accurate information and timeliness of payer systems. Center for Restorative Surgery at Maple Grove will send statements and/or provide notifications to patients for any outstanding balances and will help patients resolve them by discussing payment options.
  • All patients have the opportunity to contact the Center for Restorative Surgery at Maple Grove regarding payment arrangements.
  • Patients with no active insurance coverage are required to pay for their procedure in full prior to the day of service. Patients will be refunded or billed the difference if the procedure changes from what has been estimated prior to the day of service.
• Payer Discrepancy
  • If a claim is denied (or is not processed) by a payer due to a Center for Restorative Surgery at Maple Grove error, Center for Restorative Surgery at Maple Grove will not bill the patient for any amount in excess of that for which the patient would have been liable had the payer paid the claim.
  • If a claim is denied (or is not processed) by a payer due to factors outside of Center for Restorative Surgery at Maple Grove’s control, Center for Restorative Surgery at Maple Grove will follow up with the payer and patient as appropriate to facilitate resolution of the claim. If resolution of the claim does not occur after reasonable follow-up efforts, Center for Restorative Surgery at Maple Grove may bill the patient.
• Patient Collections
  • At least three statements for collection of account balances are mailed to patients to the current address on file. It is the patient/guarantor’s obligation to provide a correct mailing address at the time of service or upon moving.
  • With billing statements, letters, phone calls and other approved means of communication, the Center for Restorative Surgery at Maple Grove will take diligent follow up actions to contact patients to resolve outstanding balances within 120 days. If accounts are not resolved at the conclusion of the billing statement process, qualifying outstanding balances may be referred to a third-party collection agency.
• Customer Service
  • During the billing and collection process, Center for Restorative Surgery at Maple Grove and its teammates will provide quality customer service by implementing the following:
    • After receiving communication from a patient regarding a billing question or dispute, Center for Restorative Surgery at Maple Grove teammates will return phone calls to patients promptly as possible, but no more than one business day after the call was received.