/policies/,/policies/administrative/,/policies/administrative/uwmf/,/policies/administrative/uwmf/uwmf-wide/,/policies/administrative/uwmf/uwmf-wide/patient-business-services/,

/policies/administrative/uwmf/uwmf-wide/patient-business-services/113021.policy

201411307

page

100

UWMF,

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

Prepayment and Time of Services Payment - UWHC Sites (113.021)

Prepayment and Time of Services Payment - UWHC Sites (113.021) - Policies, Administrative, UWMF, UWMF-wide, Patient Business Services

113.021

PBS 12: Prepayments
Updated: 9-1-07
1

University of Wisconsin Medical Foundation
Patient Business Services Policies & Procedures
TIME OF SERVICE PAYMENTS
UWHC SITES
(aka Self Payments)


_ __ New _X_ Revised

If Revised, Supersedes Policy Dated: 8-1-05

Effective Date: 9-1-07

Policy Number: PBS-12
Approved By (Name): Connie Kinsella, Vice President, Patient Business Services



Purpose
To define a process for collecting payment for services not generally covered by insurance for
which we require payment before the service will be rendered. Examples of such services are
cardiovascular screening and virtual colonoscopy. This policy should not be applied to
patients who are uninsured, unless they are receiving one of the services noted above.
Prepayment of cosmetic services and non-covered bariatric surgery is also required. Please refer
the separate policies which have been developed relating to those services.


Policy
1. Payment for lower procedures/services where the price is known prior to the service being
rendered (e.g., virtual colonscopy, cardiovascular screening, CT Calcium scoring) should be
collected at the time of check-in.


Procedure
1. REGISTRATION HUB STAFF
a. Select Sign-in

PBS 12: Prepayments
Updated: 9-1-07
2



b. Select Other Payment



PBS 12: Prepayments
Updated: 9-1-07
3
c. Complete the fields noted with the stop sign. See the grid at the end of the policy for
current fees for procedures requiring payment at the time of check-in.

For Post mtd, enter 6 (for later distribution/prepayment). Source is cash, check, or
credit card. When finished, click accept. This will take you back to the sign-in or
check-in screen.



PBS 12: Prepayments
Updated: 9-1-07
4
d. Complete the Sign-in and/or Check-in processes as normal, except, when you get to
the co-pay screen, click to the “Do Not Bill Insurance” box (this should be done even
if the patient does not have insurance).



2. PROVIDER
a. When the provider renders the service, he/she must add a modifier of PRE to the
professional services that were paid at the time of sign/check-in. This will ensure
that when the professional charge is posted to Epic, it will be routed to Special Billing
so the payment can be matched to charge.


3. UWHC CHARGE ENTRY STAFF – Post charges via normal procedures. Send an e-mail
to: ptacct@uwhealth.org information UWHC Patient Business Services that a bill hold
needs to be placed on the patient’s account for the services rendered. Provide the
following detail in the e-mail: Patient Name, Patient MRN, Date of Service, Provider,
Services Received.


4. UWMF SPECIAL BILLING STAFF
a. One the charge has been posted, the presence of the “PRE” modifier will cause the
charge to route to Special Billing staff. They will distribute the payment to the charge
and refund the facility amount to UWHC.


PBS 12: Prepayments
Updated: 9-1-07
5

Vascular Screening Services
UWHC Codes/Fees UWMF Codes/Fees
Total Fee To Be
Collected
Vascular Health
Screening (CIMT)
0126T-52, SCR, PRE
$235.00
0126T-52, SCR, PRE
$60.00
$295.00
Abdominal Aortic
Aneurysm (AAA)
Screening
93979-TC, 52, SCR,
PRE
$55.00
93979-26, 52, SCR,
PRE
$15.00
$70.00
Stroke (Carotid)
Screening
93882-TC, 52, SCR,
PRE
$55.00
93882-26, 52, SCR,
PRE
$15.00
$70.00
Peripheral Arterial
Disease (ABI)
Screening
93922-TC, 52, SCR,
PRE
$55.00
93922-26, 52, SCR,
PRE
$15.00
$70.00
Virtual Colonoscopy Services
Done at Research
Park
CDM - 80551161
CPT - 74150-TC &
73675-TC
$807.70
0066T-26, PRE or

0067T-26, PRE
Both are $379.00
$1,186.70
Done at UWHC CDM - 80221161
CPT - 74150-TC &
73675-TC
$807.70
0066T-26, PRE or

0067T-26, PRE
Both are $279.00
$1,186.70
CT Calcium Scoring
Done at Research
Park
CDM - 80554454
CPT - 71250-TC-52
$257.70
71250-26,52 PRE
$136.00
$393.70
Done at UWHC CDM - 80224454
CPT - 71250-TC-52
$257.70
71250-26,52 PRE
$136.00
$393.70


Attachments
None

References
Bariatric Surgery Policies
Transformations/Cosmetic Services Policy