Medical debt collectors frustrated by FCC cellphone ruling

By Beth Kutscher  | August 29, 2015

A new Federal Communications Commission ruling could challenge medical-debt collectors seeking to contact patients on their cellphones.

The FCC this summer issued an interpretive ruling on the decades-old Telephone Consumer Protection Act after a number of petitioners asked for clarity on issues including autodialing, consent to call and reaching wrong numbers, particularly for cellphones.

The petitioners wanted greater flexibility. But the FCC made it clear that the onus is on debt collectors to confirm express consent before autodialing a cellphone. The challenge, debt collectors say, is that the ruling leaves no leeway when a collection agency doesn't know they have the wrong number for someone.

The industrywide order provides some exceptions for appointment reminders and test results. But the FCC “was very explicit” that the exemptions did not extend to bill collection efforts, said Robert Föehl, general counsel at ACA International, the Association of Credit and Collection Professionals.

Medical-debt collectors say they're working quickly to comply with the changes. Penalties start at $500 and can swell to $1,500 for willful violations.

Hospitals need to be aware of the rule changes because they can be held liable even when it is their vendors who fail to comply with regulations, said George Buck, president of Frost-Arnett, a Nashville-based collections company. “The healthcare world is behind the curve when it comes to getting consent,” he said.

Providers must get express written consent to call patients on their cellphones about billing issues.

Despite record-high levels of insurance coverage, a number of health systems are reporting an increase in bad debt as more patients come in with high-deductible plans. Each year, that adds up to millions of calls from healthcare debt collectors.

Parallon Business Solutions, the revenue-cycle management company owned by HCA, has been trying to reduce the number of autodial calls it makes. “We find it makes no sense to dial someone 50 or 60 times,” said Leslie Newman, Parallon's managing counsel.

Still, she described the calls as “highly effective initially”—within the first 20 to 30 attempts.

Many of those unanswered calls go straight to an automated voicemail message that's little more than a recording of a phone number, without a name attached. And that's precisely the situation where debt collectors can now get into trouble.

The FCC allows debt collectors to mistakenly dial a number one time without penalty—but if that call goes to a generic voicemail message, debt collectors have no way of knowing that they're now on the hook for up to $500 per call going forward. “There's a practical problem,” Föehl said. “There's no way to be 100% compliant.”

ACA International immediately filed a lawsuit challenging the interpretive ruling, arguing that it is at odds with Congress' original intent. The group is hoping for a resolution within a year, but until then, the ruling stands, Föehl said.

The growing scrutiny on medical- debt collection practices extends far beyond the Telephone Consumer Protection Act, or TCPA. State and federal regulators have put the healthcare industry on watch, including the Consumer Financial Protection Board, which held a public hearing in December to address the “unnecessary and frustrating challenges” people face after they incur a medical bill.

A study by the board last year found that medical debt accounts for 52% of collection marks on credit reports. Moreover, consumer credit scores overstate the effect of medical debt, even when overdue bills are paid.

The number of TCPA-related lawsuits increased 560% between 2010 and 2014, according to ACA International, citing numbers from WebRecon, which helps debt collectors identify problematic phone numbers.

Medical debt was the reason for 14% of complaints filed with the Consumer Financial Protection Board last December, WebRecon found. And most complaints came from people pursued for debt they did not owe.

The ruling is likely to become increasingly relevant as cellphones replace landlines. Nearly 60% of households are primarily or exclusively wireless, according to a 2014 survey from the Centers for Disease Control and Prevention.

http://www.modernhealthcare.com/article/20150829/MAGAZINE/308299969/medical-debt-collectors-frustrated-by-fcc-cellphone-ruling

ICD 10 - 2015 Orthopedics power point on surgery and fracture coding

Orthopedics_powerpoint_ppt_presentation

Physicians Liens

Physicians Liens

By Mark R. Raddatz of Kohn Law Firm S.C.  - Please click above for full article.


It is important to note that physicians may contract with their patients, through the patient's attorney of record, by use of a Physician/Doctor Lien. These documents are often simple, one page agreements, and set forth that the physician is given a lien on any settlement, claim, judgment, or verdict resulting from the underlying accident or illness. Furthermore, such documents have the patient acknowledge that the debt is due, recognize that such agreement is for the protection of the physician, and finally, that payment is not contingent upon the outcome of the personal injury case. The documents are signed by both the patient and their attorney, and may be filed with the court of record for the personal injury case.

ICD-10 will help physicians treat the “whole patient” | EHRintelligence.com#_

ICD-10 will help physicians treat the “whole patient” | EHRintelligence.com#_

MVAIC- Who qualifies

 

Do-you-qualify? Click here or read below

 

 

Official requirements for MVAIC benefits;

• You were involved in a motor vehicle accident in New York.
• You were a resident of New York when the motor vehicle accident occurred.  Under special circumstances, residents of other states may be eligible for MVAIC benefits.  If you were not a resident of New York when the accident occurred and have questions pertaining to eligibility, please contact us by phone at (646)205-7800, or via email at HelpDesk@mvaic.com. 
• You have no other automobile insurance available to you. If you or any of your household relatives own an insured motor vehicle, you will be required to file a claim with that insurance company to see if you are covered under that policy for benefits.
• You were NOT the owner of the uninsured vehicle that was involved in the accident.
• You were NOT the spouse of the uninsured vehicle’s owner, and a passenger in that uninsured vehicle.

Additionally, there are timeframe requirements that must be adhered to.  If these timeframes are not met, your eligibility could be affected...

• The motor vehicle accident must be reported to the Police (Peace Officer) within 24 hours of the accident occurring.
• A Notice of Intention (NOI) is submitted to MVAIC within 90 days of the accident, if the accident was with a Hit & Run or unidentified motor vehicle.
• A Notice of Intention (NOI) is submitted to MVAIC within 180 days of the accident, if the accident was with an identified motor vehicle. 

The requirements above are set forth in Article 52 of the New York Insurance Law.

All claims submitted to MVAIC are reviewed for eligibility.  If you have any questions, please contact us by phone at (646) 205-7800, or via email at HelpDesk@mvaic.com. 

 

 

Completing The NF-2 Form Within 30 days - One of the most important first steps

The Application for No-Fault Benefits officially notifies the insurance carrier of your claim. It also is usually the first written document associated with the injury details of your car accident. When listing your injuries, don't leave anything out. What you consider to be minor in the beginning  can become problematic over a few days or weeks.** I know of someone who didn't file  NF-2 form until months later- then wanted treatment to be billed to No Fault-but their carrier specifically told me the claim was closed because of the patient failing to file his form within the required time frame. It is important to file the NF-2 form as soon as possible .

 If you have an injury recorded on file from the beginning on your paperwork, this helps to make medical claims processing easier for your insurance carrier when they receive treatment bills from your health care provider's office.  Some health care provider's offices have these forms available for you to fill out at the time of your treatment and can assist you with the form should you have questions with any part of it .  They can send it directly to your insurance carrier too.


Healthcare Provider can send out your NF-2 Form.
"Therefore, it is clear that the regulation does permit a health care provider to send, on behalf of an EIP, the NF-2 directly to the insurer, which may help in ensuring that the EIP meets the written notice requirement necessary to receive No-Fault benefits."

Calling your insurance carrier after the car accident is highly recommended. They will issue you a claim number and the name of the person handling your claim after you report the accident to them. This is important information for when you go to seek medical treatment.  Keep the claim number and the insurance claim representative's name with phone number handy when going to any medical care facility for treatment of your injuries. There is a spot on the NF-2 Form where you will need to provide this information.

You have only 30 days from the date of the accident to file a No-Fault Application (NF-2) Form with your insurance company – and only under certain circumstances will a grace period be allowed.
A serious injury where the injured party is hospitalized for weeks may be given an additional 30 days to get their form in, but don't depend or expect a grace period from your carrier. Carriers like to deny claims and it's an easy denial to issue if your NF-2 form was never received or received too late.


Access pages 5-7 to view and print out from this link :  NF2- Form

Coding Topic - Consult Downcoded to a lower E/M level ?

What Documentation Is Required?

In order for an E/M service to be considered a consultation, the following criteria must be met and documented:

• A request for a consultation, along with the reason  for a consultation, must be documented by the consultant in the patient's medical record and included in the patient's medical record of the referring practitioner.
• An opinion is rendered by the consulting practitioner. This opinion, along with any other service provided, is documented in the patient's health record.
• A written report of the consultant's findings and opinion or recommendation is communicated back to the requesting practitioner. This report is known to  include a thank-you letter for the consultation request and state exactly what the consultant's opinion is concerning the patient's medical problem.

CPT Assistant, July 2007 indicates that “there may be circumstances when a consultation is initiated by sources other than a physician, such as a physician assistant, nurse practitioner, doctor of chiropractic, … social worker, lawyer, or insurance company.” This helps to explain who can be considered another provider or healthcare entity. Reporting a consultation would be appropriate if the service was at the request of one of these professionals. -

Documentation is the key to getting paid for the consult done.

 It is a lack of proper documentation that leads to a carrier  determination  to downcode  consultation codes to a lower E/M level of service.

If you documented a consult properly and still received a downcode, appeal it immediately and attach the report made out to the referring physician.  Point out to the carrier the referring physician requesting the consultation, the report on record and the rendered opinion given from the physician performing the consultation.

Don't settle for the downcode amount when a consultation has been performed.Appeals that show full proof of the consultation performed will be reconsidered by the insurance carrier for the full payment due.



Julie Pisacane, CCA, CEMC

Member of AHIMA and AAPC