BILLING AND COLLECTION POLICY

Scope.  This Billing and Collection Policy (the “Policy”) applies to collection of medical debt from individual patients of Centrasota Oral and Maxillofacial Surgeons, P.A. d/b/a Centrasota Oral Surgeons (“Centrasota”). References to the word “patient” refer to the patient receiving treatment or services from Centrasota and/or the person who is responsible for paying for such treatment or services.

Policy.  It is Centrasota’s policy to pursue collection of medical debt balances from all Centrasota patients for care and services provided by Centrasota. When collecting medical debt, Centrasota will follow and comply with all applicable laws and regulations, which may include the Fair Debt Collection Practices Act and the Minnesota Debt Fairness Act.

Payment.  Patients must make payment to Centrasota in full at the time service is provided, unless other arrangements have been made in advance.

Insurance. As a service to its patients, Centrasota will file a patient’s insurance form(s) based on the insurance information the patient provides. There is no guarantee that a patient’s insurance will cover Centrasota’s services. A patient is fully responsible for all amounts due to Centrasota, regardless of insurance coverage. It is the patient’s obligation to confirm its insurance coverages and comply with any insurance requirements. Patients must pay their account in full, including, but not limited to, making payment for any deductibles and co-payments and other amounts not covered by insurance.

Communication with Patients about Medical Debt.

Centrasota will communicate with its patients regarding medical debt using any of the following methods: (i) in person when the patient visits any of Centrasota’s clinics, (ii) with billing statements, notices or letters delivered electronically or through U.S. mail, and (iii) via telephone calls, text messages, e-mail or other electronic applications.

If a patient’s insurance does not pay the claim in full, Centrasota will mail the patient a billing statement reflecting payments and credits made to the patient’s account, and remaining amounts due and owing for Centrasota’s services. Patients must pay the amounts due and owing reflected within its billing statements in full within 30 days after the billing statement date.

Centrasota will impose late fees in the form of finance charges outlined in this Policy if a patient fails to pay its balance in full within the 30-day period.

Centrasota will continue to have billing statements sent to the patient via mail periodically until the full amount reflected in the statement is paid in full.

All written communications from Centrasota to the patient regarding any outstanding medical debt shall contain Centrasota’s contact information for patients to ask questions or dispute amounts and entries reflected within any billing statement, and, when initially contacting a patient by mail to collect a medical debt, a disclosure in a type size or font which is equal to or larger than the largest other type of type size or font used in the text of the notice, that includes and identifies the Minnesota Attorney General’s general telephone number, and states: “You have the right to hire your own attorney to represent you in this matter”.

For Centrasota to service a patient’s account or to collect any amounts a patient may owe, Centrasota may also contact the patient by telephone at any telephone number associated with the patient’s account, including wireless telephone numbers, which could result in charges to the patient. Centrasota may also contact a patient by sending text messages or e-mails, using any e-mail address the patient provides to Centrasota. Methods of contact may include using pre-recorded and artificial voice messages and/or use of an automatic dialing device, as applicable, unless the patient expressly requests that Centrasota cease communication utilizing such methods.

Finance Charges.  Centrasota will charge a finance charge for each day that a patient’s account is not paid in full after it becomes due and owing.  Finance charges will accrue 30 days after the date of the initial billing statement.  The present periodic rate to calculate the finance charge is .66% per month, corresponding to an annual percentage rate of 8%.

Billing Errors or Additional Information.

If a patient thinks its billing statement is wrong, or if it needs more information about a transaction listed on the billing statement, the patient should provide Centrasota notice.

When providing Centrasota notice, the patient should include the following information:

• Patient name and account number;
• The dollar amount of the suspected error; and
• Description of the error and explanation why the patient believes there is an error, and if the patient needs more information, a description of the item it is unsure about.

If Centrasota determines or receives notice that one of its bills may contain one or more billing errors, Centrasota must, within 30 days after it determines or receives notice that a patient’s bill may contain one or more billing errors, notify the patient: (i) of the potential billing error, (ii) that Centrasota must review the bill and correct any billing errors found, and (iii) that while it conducts its review, it must not bill the patient for any health treatment or service subject to review for potential billing errors.

While Centrasota conducts its review, the patient does not have to pay for, and Centrasota will not bill the patient for, any health treatment or service subject to review for potential billing errors, but the patient is still obligated to pay those parts of the patient’s bill for any health treatment or service not subject to review.  Centrasota may bill the patient for the health treatment and services that were reviewed for potential billing errors only after its review is complete, any billing errors are corrected, and the notice outlined below is transmitted to the patient.  While Centrasota investigates the patient’s question, Centrasota will not report the patient as delinquent or take any action to collect the amount in question.

Within 30 days of Centrasota completing its review, it will notify the patient that the review is complete and explain in detail how any identified billing errors were corrected or why it did not modify the bill as requested, and include in Centrasota’s notification, any applicable coding guidelines, references to health records and other relevant information.

If, after completing its review and correcting any billing errors, Centrasota determines a patient overpaid Centrasota under the bill, Centrasota shall, within 30 days after completing its review, refund the amount the patient overpaid under the bill to the patient.

Use of Collection Agencies. If the patient does not make payment in full within 90 days after the original billing statement was mailed, Centrasota may turn the patient’s account over to a collection agency or law firm. Pursuant to Minnesota law, Centrasota will not report the patient’s medical debt to a credit reporting agency or a consumer reporting agency.

Ending Collection Activities. Once Centrasota is paid in full for a patient’s medical debt, it exhausts all collection efforts without success in obtaining payment, the patient’s account is deemed uncollectible pursuant to any arrangements Centrasota has with any collection agency or law firm, or if the patient’s account otherwise goes into bankruptcy, Centrasota will identify such medical debt as uncollectable or satisfied, and, except as otherwise provided for within this Policy, cease further collection efforts with respect to that patient’s account. 

However, notwithstanding the foregoing, in the event a patient requests another treatment or service from Centrasota and that patient has an outstanding balance that was previously deemed uncollectible pursuant to this Policy for reasons other than bankruptcy, Centrasota will request that the patient bring its account current and take other actions to collect the patient’s balance, even if previously deemed uncollectible.  Centrasota may still accept payments for a patient’s account that was previously deemed uncollectable.

Denial of Care. Centrasota will not deny any medically necessary health treatment or services to a patient or to any member of the patient’s family or household because of current or previous outstanding medical debt owed by the patient or any member of the patient’s family or household to Centrasota, regardless of whether the health treatment or service may be available from another health care provider.  However, as a condition of providing any medically necessary heath treatment or services in such circumstance, Centrasota may require the patient to enroll in a payment plan for the outstanding medical debt owed to Centrasota. The payment plan must be reasonable and must take into account any information the patient discloses regarding the patient’s ability to pay. Before entering into the payment plan, Centrasota shall notify the patient that if the patient is unable to make all or part of the agreed-upon installment payments, the patient must communicate the patent’s situation to Centrasota and must pay an amount the patient can afford. 

For purposes of this section, “medically necessary” means: (i) safe and effective, (ii) not experimental or investigational, except as provided in 42 CFR 411.15(o), (iii) furnished in accordance with acceptable medical standards of medical practice to diagnose or treat the patient’s condition, or to improve the function of a malformed body member, (iv) furnished in a setting appropriate to the patient’s medical need and condition, (v) ordered and furnished by qualified personnel, (vi) meets, but does not exceed, the patient’s medical need, and (vii) is at least as beneficial as an existing and available medically appropriate alternative.

Questions. If a patient has any questions regarding this Policy or needs any additional information, please contact Centrasota at:

CENTRASOTA ORAL SURGEONS
3950 Veterans Drive Suite 100 St. Cloud, MN 56303
(320) 252-3611
[email protected]