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Administrative (Non-Clinical) Policy
This administrative policy applies to the operations and staff of the University of Wisconsin Hospitals and
Clinics Authority (UWHCA) as integrated effective July 1, 2015, including the legacy operations and
staff of University of Wisconsin Hospital and Clinics (UWHC) and University of Wisconsin Medical
Policy Title: UW Health Limits for Patient Account Settlements, Discretionary
and Non-Discretionary Write-Offs/Adjustments and Patient Refunds
Policy Number: 2.31
Effective Date: November 1, 2016
Chapter: Fiscal Affairs
To establish approval guidelines for UW Health patient account settlements, discretionary and non-
discretionary adjustments/write-offs and patient refunds.
II. POLICY ELEMENTS
The settlement, write-off and refund of patient accounts will be approved by individuals at or above the
established approval levels according to the amount of the adjustment.
A. With the exceptions noted below, all adjustments of a patient accounts must be approved by the
two highest levels based upon the following chart:
Adjustment Amount Approval Level
$0-$499 Patient Accounting Staff Member
$500-$1,999 Patient Accounting Team Leader
$2,000-$4,999.99 Supervisor of Patient Accounting
$5,000-$14,999 Manager of Patient Accounting
$15,000-$74,999 Director of Revenue Cycle
>$75,000 VP of Revenue Cycle
B. By way of example: the Manager of Patient Accounting and the Director of Revenue Cycle must
approve a $55,000 write-off/adjustment.
C. Additionally, Patient Account Representatives can extend to non-contracted third parties a 5%
discount not to exceed a total discount of $2,500 as a prompt payment discount (e.g., payment to
be received within 30 days of the filing date).
D. Additionally, Patient Account Representatives can extend to patients up to a 15% discount not to
exceed a total discount of $2,500 to settle patient balances (e.g., payment to be received same day
as offer). Any approved discount, combined with any uninsured discount already posted may not
exceed a 15% total discount.
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E. Exceptions to the two-level approval requirement:
1 For accounts classified, in accordance with UWHC Business Office policies, as hardship or
charity care write-offs/adjustments only the highest applicable approval level is required to
review and approve the write-off/adjustment.
2 Non-discretionary system and manual adjustments posted by the Cashier's staff, that result in
a variance between the expected and actual reimbursement greater than $10,000 are reviewed
and approved by the Director of Revenue Cycle.
Sr. Management Sponsor: VP, Revenue Cycle
Author: Director, Revenue Cycle
Approval Committee: UW Health Administrative Policy and Procedure Committee
UW Health Chief Administrative Officer
Previous revision: 092013
Next revision: 112019