CRCR Point-of-Service Collections 4 — Questions and Answers
Question 1: Under the Affordable Care Act, non-profit hospitals must have a financial assistance policy (FAP) that includes all of the following EXCEPT:
- Eligibility criteria for free or discounted care
- The basis for calculating amounts charged to eligible patients
- A list of providers covered by the FAP
- A requirement that patients purchase supplemental insurance (Correct answer)
Correct answer: A requirement that patients purchase supplemental insurance
ACA Section 501(r) requires non-profit hospitals to have a FAP covering eligibility criteria, calculation basis, and covered providers, but does NOT require patients to purchase any insurance.
Question 2: A patient's coinsurance is 20% after a $1,000 in-network deductible, which has been fully met. The allowed amount for today's procedure is $800. What is the patient's POS responsibility?
- $800
- $160 (Correct answer)
- $640
- $200
Correct answer: $160
Since the deductible is fully met, only the coinsurance applies: 20% of $800 = $160.
Question 3: Which of the following self-pay discount strategies is considered a best practice and least likely to create compliance risk?
- Offering self-pay patients a discount equal to what Medicaid would pay
- Offering a prompt-pay discount tied to payment at time of service, consistently applied to all self-pay patients (Correct answer)
- Discounting only patients who threaten to leave
- Matching competitors' prices on an ad hoc basis
Correct answer: Offering a prompt-pay discount tied to payment at time of service, consistently applied to all self-pay patients
A consistently applied prompt-pay discount for self-pay patients is transparent, non-discriminatory, and defensible as a legitimate business practice that encourages POS payment.
Question 4: Which payment technology trend has most directly increased patient willingness to pay balances at point-of-service?
- Paper statements mailed 90 days post-visit
- Mobile and contactless payment options integrated into the check-in workflow (Correct answer)
- Third-party debt collection agencies on-site
- Requiring payment by certified check only
Correct answer: Mobile and contactless payment options integrated into the check-in workflow
Integrating mobile and contactless payment options into the check-in process reduces friction and aligns with consumer payment preferences, increasing POS collection rates.
Question 5: A patient has a health savings account (HSA). How should staff handle a copay collection when the patient presents an HSA debit card?
- Refuse HSA cards as they are not standard payment methods
- Process it like any other debit card transaction (Correct answer)
- Require the patient to show their HSA account balance first
- Apply a surcharge because HSA cards have higher processing fees
Correct answer: Process it like any other debit card transaction
HSA debit cards function like standard debit cards for eligible medical expenses and should be accepted and processed as any other card payment.
Question 6: The No Surprises Act (2022) primarily affects point-of-service collections by:
- Eliminating all patient cost-sharing for emergency services
- Requiring good-faith cost estimates for scheduled services and restricting surprise billing from out-of-network providers (Correct answer)
- Mandating that all hospitals collect 100% of patient balances upfront
- Prohibiting payment plans for uninsured patients
Correct answer: Requiring good-faith cost estimates for scheduled services and restricting surprise billing from out-of-network providers
The No Surprises Act requires providers to give patients good-faith cost estimates before scheduled services and limits surprise billing when patients unknowingly receive out-of-network care.
Question 7: A front-end registration team is tracking 'pre-service collections as a percentage of total patient-responsible balances.' This metric is BEST used to:
- Measure payer contract performance
- Benchmark POS collection effectiveness and identify staff training needs (Correct answer)
- Calculate the organization's days in AR
- Determine the appropriate charity care discount percentage
Correct answer: Benchmark POS collection effectiveness and identify staff training needs
Pre-service collections as a percentage of patient-responsible balances directly measures how effectively the team captures revenue at the front end and reveals training gaps when percentages are low.
CRCR Point-of-Service Collections 4
Under the Affordable Care Act, non-profit hospitals must have a financial assistance policy (FAP) that includes all of the following EXCEPT: