Collecting from Patients May Get Tougher When New ACA Financial Rules for Non-profit Hospitals Became Effective January 1, 2014

The IRS is authorized to strip tax-exempt status from ‘willful and flagrant’ violators of ACA financial rules; pathologists and clinical laboratory managers should take notice Hospitals and other providers already find it more difficult to collect larger amounts of money from patients who have high deductible health plans (HDHPs). That degree of difficulty increased on January 1, 2014. That’s the date when new regulations of the Affordable Care Act (ACA) kicked in that govern how hospitals can...

Hospitals Generally Charge Self-pay Patients Top Price for Care, but Some Providers Now Offer Deep Discounts for Patients Who Pay with Cash

Clinical laboratories and pathology groups may want to review the prices they charge insured patients versus uninsured patients There is a certain irony in the fact that hospitals and other medical providers typically charge patients without health insurance as much as three times what they charge Medicare or an insured patient. This situation is getting increased media scrutiny, which is one reason why clinical laboratories and pathology groups may want to review their own policies for...

California’s New Health Insurance Exchange May be Unexpectedly Low, but Co-pays for Outpatient Services Are Relatively High

High Co-pays for Lab Tests May Create a Collection Nightmare for Clinical Laboratories As new facts about the prices of premiums and the amount of patient co-pays for California’s health information exchange—called Covered California—are published, the news is not likely to be favorable for clinical laboratories and anatomic pathology groups in the Golden State. Of particular note is that Covered California has published a requirement that patients will be charged a $35 co-pay for medical...
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