Revised policy at NGMC increases patient accountability for payment of services

GAINESVILLE - Northeast Georgia Medical Center (NGMC) announces changes in the organization's payment for services policy that shifts to patients more personal accountability for payment of services, according to NGHS President Jim Gardner.

The revised policy covers non-emergent services provided in the hospital's emergency department, as well as elective services, such as imaging procedures and elective surgeries.

Due to the increasing amount of self-pay patients and bad debt write-offs, a national trend is emerging to screen non-emergent or elective services and require patients to pay prior to delivery of those services.

"Northeast Georgia Medical Center has always pursued collection of payment for services rendered unless the patient qualifies for charity care," Gardner said.

"Requiring payment for non-emergency and elective services before they are rendered will increase patients' stewardship responsibilities for using health care resources wisely and will help ensure the continued availability of services for the community."

Gardner said roughly one-third of the patients seeking care in the emergency department are non-emergent.

"Northeast Georgia Medical Center has a responsibility to the community to maintain access to emergency services for true emergency patients by minimizing inappropriate use of the emergency department for primary health care services," he said.

All patients who come to the emergency department are evaluated by an emergency room physician or mid-level provider. Consistent with the Emergency Medical Treatment and Active Labor Act (EMTALA), if the patient is emergent, the patient is treated regardless of their ability to pay or stabilized for transfer to another facility that can provide the appropriate level of care.

Beginning in June, if the physician determines the patient is non-emergent, the patient will have the option to remain in the ED for treatment of the non-emergent condition, but will be required to pay a portion of the charges before services are rendered. Uninsured patients will be required to pay a $150 deposit and insured patients will be required to pay their co-payment amount prior to treatment.

"Education will play an important role in helping patients better understand appropriate use of emergency facilities. A financial counselor will provide non-emergent patients with information on primary care providers in the community to help them choose appropriate sources of care," Gardner said.

"We believe that redirection of non-emergent patients out of the emergency department is a very responsible decision that will protect critical emergency resources for our community."

All patients who come to the emergency department receive a medical screening and those who have emergent conditions will not be asked to pay for services before they are rendered.

In April, NGMC began requiring a portion of payment prior to the delivery of elective services, such as imaging services and elective surgeries. For elective procedures, patients are notified of the requirement of payment prior to the service being provided. NGMC requires uninsured patients to pay a down payment of 25 percent of the patient liability, or $500, whichever is less. The patient is also asked to sign a promissory note for the balance. If the patient states they cannot pay and they do not meet the charity criteria, the procedure is postponed until payment arrangements can be made. Insured patients are required to pay their co-payment amount prior to service delivery.

In cases where the treating physician believes the procedure is clinically urgent, additional levels of review are available as deemed necessary. If the patient is eligible for charity, the charges are discounted based on a sliding scale.