When to refer patients to a financial counselor

November 19, 2015  //  FOUND IN: Announcements, Updates & Resources

Any time a patient wants to pay 100% in full for an item or service and asks not to submit a bill to his or her insurance, immediately refer the patient to a Patient Financial Counselor (PFC).

Email: PFC-counselors@med.umich.edu

Phone: 734-232-2621 (local) or 877-326-9155 (toll free)

Due to an expanded patient right under HIPAA, health care providers are required to restrict disclosure to a patient’s health plan if the patient asks that the provider not bill insurance for an item or service and the patient agrees to and does pay 100% in full for that item or service. A patient may make this request to anyone, such as a physician, nurse or inpatient or outpatient clerk, for either inpatient or outpatient services.

Since these requests are infrequent, a process has been developed for the UMHS Patient Financial Counselors to handle each request.  Faculty and staff who encounter patients making these requests should immediately refer the patient to a PFC, unless the patient making the request has presented to the Emergency Department (ED) after hours, in which case the ED registrars will begin the process directly for the patient.

For more information, see: UMHS Compliance Topic, Restricted Disclosure – PHI Release Restriction with Self Pay in Lieu of Payor.