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/policies/administrative/uwmf/uwmf-wide/patient-business-services/113036.policy

20150237

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

Uninsured Discount Policy (113.036)

Uninsured Discount Policy (113.036) - Policies, Administrative, UWMF, UWMF-wide, Patient Business Services

113.036

PBS 36: Uninsured Discounts
9-1-07

1

University of Wisconsin Medical Foundation
Patient Business Services
Policies & Procedures
UNINSURED DISCOUNT POLICY


__X __ New ____ Revised

If Revised, Supersedes Policy Dated:

Effective Date: September 1, 2007

Policy Number: 36
Approved By (Name): Connie Kinsella, VP, Patient Business Services


Purpose
It is the policy of UWMF to identify uninsured patients and to bill them at a discounted amount
for their services if they do not carry insurance coverage. UWMF will provide a discount to
those uninsured patients of at least 5% via an ‘Uninsured Discount’. Patients may be eligible for
higher discounts through the Community Care program if they meet the eligibility criteria.

Definition of Uninsured Patient: A patient who does not have any third party health care
coverage by either (a) a third party insurer, (b) an ERISA plan, (c) a federal health care program
(including, without limitation, Medicare, Medicaid and TRICARE), (d) Worker’s
Compensation, (e) Medical Savings Account, or (f) other coverage for all or any part of the bill,
including claims against third parties covered by insurance to which UWMF is subrogated, but
only if payment is actually made by such insurance company.

Policy
1) For patients registered without insurance coverage on either a Personal/Family or
Confidential account type, the Uninsured Discount will be automatically applied as the
charges are entered into the Epic billing system (HealthLink). The discount is permanent and
will be displayed in Account Maintenance as well as the patient’s billing statement.
2) Patients will be informed on their billing statement what this discount is and that they may be
eligible for an additional adjustment if they qualify for UW Health’s Community Care
Program.
3) The list of exclusions includes, but is not limited to, the following;
a) Cosmetic Services (CS000-CS999)
b) Bariatric Surgery
c) Reproductive Endocrinology
d) Artificial Insemination
e) Vasectomy Reversal Services

PBS 36: Uninsured Discounts
9-1-07

2
f) Hearing Aid Services
4) Should a patient become eligible for any third party payer resource, the account will be
reclassified to that payer and the uninsured discounts will be voided.
5) When there is ‘approved’ Community Care the Uninsured Discount will be voided.
6) The patient can pay in installments, if desired.
7) Accounts will be referred to bad debt at the discounted amount.
8) On a retrospective, request-only basis, patients with insurance coverage who had their service
denied as non-covered will be granted the 5% Non-Covered Discount.


Attachments
None


References
Community Care Policy