Collection of Health Insurance Co-payments, Deductibles, Coinsurance

Objective

To set forth CUIMC’s obligation to collect co-payments, deductibles, and coinsurance from patients.

Policy

Most healthcare insurance plans or policies require patients to share the cost of the health insurance benefit. Cost sharing is effectuated through the imposition of health insurance co-payments, deductibles and coinsurance. These cost sharing mechanisms are imposed by the individual insurance company and are part of the insurance company’s contract with the patient.

Routine or consistent waiver of the patient’s cost sharing responsibility is considered by government regulators and private insurers to be an abusive practice and may be seen as a violation of a private health care insurance contract (and, possibly, insurance fraud).

• All co-payments, deductibles and coinsurance must be collected, to the extent feasible, at the time of service.
• If the patient’s share of the bill cannot be collected at the time of service, departments should make at least three documented attempts to collect following the visit.
• The patient’s share of the bill should not be waived under a department’s financial hardship policy.

CUIMC clinicians may waive their entire fee, including co-payments, by not billing for their services.

Office for Billing Compliance
Policy#: 10032
Original Date of Issue: 1996
Revised: 3/22/2023
Reviewed: 3/1/2024