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/policies/administrative/uwmf/uwmf-wide/patient-business-services/113010.policy

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Policies,Administrative,UWMF,UWMF-wide,Patient Business Services

Company Accounts (113.010)

Company Accounts (113.010) - Policies, Administrative, UWMF, UWMF-wide, Patient Business Services

113.010

PBS 14: Company Accounts
Revised: 12/5/2012
1

University of Wisconsin Medical Foundation
Patient Business Services Policies & Procedures
COMPANY ACCOUNTS


____ New _X__ Revised

If Revised, Supersedes Policy Dated: 2-1-05

Effective Date: 12/5/2012

Policy Number: PBS - 14
Approved By (Name): Connie Kinsella, Vice President, Patient Business Services


Purpose
To define the process for establishing Company Accounts. A company account is a special
billing arrangement established with a private employer/company, local government agency,
school district, or similar organization to provide specific services that are not covered by
insurance. Examples of such services include drug screens, pre-employment physicals, and
certain employment-related immunizations.


Policy
1. Upon request, UWMF will extend a ten percent (10%) discount for select clinic-specific
services to private employers/companies, local governments/agencies, school districts, and
other similar organizations. This discount will be limited to services not covered by
insurance and for which no other payment arrangement applies.

2. All requests for Managed Care Contracts from PPOs, HMOs, self-insured employers, or
other insurance payers must be forwarded to the UWMF Contracting Department at 608-821-
4127, or mail code 414-CONTR, 7974 UW Health Ct.

3. Requests to execute a Letter of Agreement (LOA) should be submitted by Clinic Managers,
via a Company Account Request Form. These forms are available on Uconnect and can be
submitted by e-mail to the Special Billing Department at,
SpecialBillingServices@uwmf.wisc.edu. Questions or comments regarding this form or
process should be directed to the Supervisor of Special Business Services within Patient
Business Services (PBS) at 608-829-5281.

4. All patients seen under a Company Account LOA must be registered under that Company
Account and appointments for those patients must be linked to the appropriate Company
Account. This will ensure that the entity, not the patient, is billed.


PBS 14: Company Accounts
Revised: 12/5/2012
2

Procedure

Clinic Manager

1. When contacted by an entity, regarding entering into a LOA for services, the Clinic Manager
should inform the entity of UWMF’s standard reimbursement terms for such arrangements
(i.e., (i) 10% discount, provided that payment is received within 30 days of the date of
invoice, and (ii) patients/services must be identified up-front as falling under this
arrangement).

2. If the entity is willing to proceed with the LOA, the Clinic Manager should submit a
Company Account Request form to the Special Billing Department. These forms are
available on-line and can be submitted by e-mail. Comments regarding this form or process
should be directed to the Supervisor of Special Business Services at 608-829-5281.

Note: Codes to be used for company physicals include those listed below. If the
company wants employee physicals to be provided, the Clinic Manager should indicate
on the request form which level to use based on the services requested by the company.
Lab or other tests will be billed in addition to the following codes. If lab tests are to be
included, the Clinic Manager should clearly articulate whether these tests will be performed
by UWMF or an outside lab (in the later case, we would only bill for the
handling/conveyance of the specimen).
 99201 - Office/OutPt Visit, New, Levl I
 99202 - Office/OutPt Visit, New, Levl II
 99203 - Office/OutPt Visit, New, Levl III
 99204 - Office/OutPt Visit, New, Levl IV


Special Billing Team (PBS)

1. The Supervisor of Special Business Services will review the request form. If approved, a
LOA will be forwarded to the Director of Patient Financial Services for signature. Two
original signed copies of the LOA will be forwarded to the company for signature. One will
be kept with the company and one will be returned to PBS.

2. Once the fully executed copy of the LOA is received back, the Special Billing Team will
establish a Company Account for the entity and will provide the Clinic Manager with this
account number, along with a copy of the executed Letter of Agreement.

3. The Special Billing Team will ensure that the ten percent (10%) discount arrangement is
appropriately linked to the Company Account.

4. A monthly invoice will be sent to the entity for all services rendered; reflecting UWMF’s full
fee and total reimbursement due after discount arrangement is applied. The monthly invoice
will be sent to the attention and address indicated in the LOA.

PBS 14: Company Accounts
Revised: 12/5/2012
3

5. The Special Billing Team will make a follow-up call or send a second request invoice if
payment is not received according to the terms of the LOA. If no response is received within
90 days of the first invoice, the patient will be billed directly.

6. The Special Billing Team will scan and maintain the original LOA.


Clinic Staff
1. When patients are to be seen under the Company Account, clinic staff must ensure that the
patient is registered under the Company Account and that the appointment is linked to the
Company Account. Central Registration staff is available at 608-287-2725 to assist clinic
staff with this process, as necessary.
a. If a patient calls for an appointment and indicates they want to have the service billed
to their company and there is no company account, tell the patient: (i) that a company
account is required and their HR representative (or whomever) should contact the
clinic manager OR (ii) that the service will be treated a self-pay and they can submit
the receipt to their company for reimbursement. (Under this updated policy, company
accounts will not be set up without an underlying agreement, so you will not be able
to create a company account and attach it to the appointment.)
b. If the service is to be treated as self pay, please follow the check out procedure
detailed in #3 below.

2. For patients seen where the appointment is tied to the company account. When the patient is
seen (after confirming that the appointment is linked to the Company Account) the provider
should record the services rendered (based on those listed in the Letter of Agreement).
Charges will drop electronically under the account the appointment is attached to. Labs
should be submitted via the interface, but lab staff must make sure the appointment is tied to
the company account. The exception to this is Handling and Conveyance of a Specimen,
CPT code 99000. If the clinic is on EpicCare, all charges will file via EpicCare. As long as
the appointment is correctly tied to the company account, there should be no issues. Note:
only those services listed in the LOA fall under the agreed upon reimbursement
arrangement and should be recorded.

3. For patients seen where the appointment will be self-pay. Post the charge and payment at the
time of check out. (Note: lab services should be “hard stopped” so that the charges do not
file via the interface. The labs should be entered on-site through this process.)
a. From the DAR or appointment desk, highlight patient, clinic on Check Out.
b. On the check out screen, click on Charges button. This will take you directly to the
Charge Entry screen.
c. From the Charge Entry screen, the appointment information will default in the from
the appointment information entered in Cadence.
d. If the charge is for a laboratory test, at Referral svc, enter the ordering MD. Note,
you will also have to change the department from lab to the provider’s correct
scheduling department (e.g., West Towne IMC, Stoughton Internal Medicine,

PBS 14: Company Accounts
Revised: 12/5/2012
4
East Towne Pediatrics, etc), as the lab is not a department associated directly
with providers.
e. Enter the diagnosis codes in Diagnoses, section (2), of the screen.
f. Enter the CPT code(s) from the encounter form in Charges, section (3). The system
will automatically populate the fees. Note: if the warning pop-up box appears
indicating there are charge errors relating to coding, contact the provider to obtain the
correct coding information.
g. In Fast Payment, section 5, enter the payment code 1014 for patient payment, the
payment source (cash, check, credit card) and the amount. If the patient is paying by
check, enter the check number as the reference number. If the patient is paying by
credit card, enter the authorization number as the reference number.
h. At Options, section (6), choose receipt. The system will generate a receipt.
i. Click Accept at bottom of screen.
j. Send the encounter form to the Supervisor of Charge Entry at PBS-Excelsior in an
interdepartmental envelope. Please attach a note to the form indicating that this
encounter has already by charge entered and needs to be scanned only. S/he will
identify the appropriate batch number and send it to Optical for scanning.



Attachments
Company Account Request Form


References
None