Credit and Collection Policies

A Hospital or Community Health Center’s Credit and Collection Policy must meet all the requirements specified in 114.6 CMR 10.00. The Division may deny or withhold reimbursement for Free Care to any Hospital or Community Health Center which fails to comply with the requirements of 114.6 CMR 10.00 until such Hospital or Community Health Center complies with the requirements. The Division will notify Hospitals or Community Health Centers of its intention to deny or withhold reimbursement. (1) Filing Requirements. Hospitals and Community Health Centers shall file their Credit and Collection Policies with the Division: (a) by October 1, 1998. Hospitals and Community Health Centers are encouraged to submit draft Credit and Collection Policies by August 1, 1998. Hospitals and Community Health Centers mayrequest anextensionfor cause by submitting a written request to the Division. Hospitals and Community Health Centers may request an extension of no more than 60 days from October 1, 1998. Hospitals and Community Health Centers are subject to the requirements set forth in 114.6 CMR 10.00 during any extension periods. (b) within 90 days of adoption of amendments to 114.6 CMR 10.00 that would require a change in Credit and Collection Policies. (c) when a Hospital or Community Health Center makes changes in its Credit and Collection Policy. (d) when two Hospitals or Community Health Centers merge and request to be paid as a single merged entity. (2) Content Requirements. (a) Table of Contents noting the location in the document of, at least, the items listed below. (b) Standard collection policies and procedures (c) Policies and procedures for collecting financial information from patients (d) Statement on whether the patient Deductible calculation is based on a calendar year, the Hospitalor CommunityHealthCenter’s fiscal year, the patient’s eligibility year, or the PoolFiscal Year. (e) Emergency Care Classification. A Hospital must provide a detailed policy on its practices for classifying persons presenting themselves for unscheduled treatment, the urgency of treatment associated with each identified classification, the location(s) at which patients might present themselves, and any other relevant and necessaryinstructionsto Hospital personnel who would see these patients. The policy must include the classifications which qualify as Emergency Care and as Urgent Care, as defined in 114.6 CMR 10.02, and other services including “elective” or “scheduled” services. (f) The policy on deposits and payment plans for qualified patients as described in 114.6 CMR 10.05(3). (g) Designation of the person or persons responsible for approving all types of Free Care determinations (h) Language used in signs notifying patients of the availabilityof Free Care and other programs of public assistance, the locations of those signs and the size and the type of signs used pursuant to 114.6 CMR 10.08. (i) Copies of individual notices of Free Care, including billing invoices, award or denial letters, and any other documents used to inform patients of the availability of assistance pursuant to 114.6 CMR 10.08. (3) Division Response. The Division will review amended policies submitted in accordance with 114.6 CMR 10.09 within 90 days of receipt to determine whether they comply with 114.6 CMR 10.00. (4) Board Approval. Within 60 days of notification that the Credit and Collection Policy has been accepted by the Division for filing, Hospitals and Community Health Centers must provide to the Division proof that the Credit and Collection Policy has been approved by the Hospital or Community Health Center’s governing board.