Billing Policy

Purpose

To provide a process to address patient’s questions regarding billing or charges for services provided by Shepherd Center.

Procedure

Written complaints

  • Incoming written documents containing questions regarding billing or charges will be routed to the Manager of Patient Financial Services for review. The Manager will review the complaint to determine if the issue is related to charges or the billing process.
  • If the complaint relates to charges only, the complaint will be routed to the appropriate clinical supervisory staff for research and response to the patient. If the complaint is related to services, the complaint will be routed following the (‘Patient/ Family Concerns/Grievance Policy’).
  • If the complaint relates to billing of the insurance carrier or guarantor, the Manager of Patient Financial Services or appointed designee will respond to the patient.

Phone complaints

  • Complaints received by phone will be handled by the Financial Counselor responsible for incoming patient inquiries. The Financial Counselor will determine if the issue is related to charges or the billing process.
  • If the patient’s complaint cannot be resolved by the Financial Counselor to the patient’s satisfaction, the Manager of Patient Financial Services will be notified to contact the patient.
  • If the complaint relates to charges only, the complaint will be routed to the appropriate clinical supervisory staff for research and response to the patient. If the complaint is related to services, the complaint will be routed following the ‘Patient/Family Concerns/Grievance Policy’.

Shepherd Center is compliant with the Federal “No Surprises” regulations. If a consumer initiates the federal patient-provider dispute resolution process, the process Shepherd Center will provide:

  • The good faith estimate we provided the patient.
  • The bill we sent to the patient.
  • Any supporting documents that help to explain why the bill is higher than the estimate.

Shepherd Center will be emailed a link to the federal dispute resolution portal where we will upload the requested documents. The dispute resolution entity will contact the us if any additional information is needed. Once a determination is made, the dispute resolution entity will notify the us and the patient.

During the patient-provider dispute resolution process, the provider and patient can continue to negotiate the bill. During this process, Shepherd Center:

  • May not move the bill into collections or threaten to do so.
  • Must pause collections if the bill is already in collections.
  • Can’t collect late fees on unpaid amounts.
  • Can’t threaten to take any retaliatory action against the patient for initiating the patient‑provider dispute resolution process.

If Shepherd Center and the patient agree on a payment amount before the dispute resolution entity makes a determination, we must notify the dispute resolution entity as soon as possible, but no later than 3 days after the settlement. Shepherd Center will complete this notice of payment settlement (PDF) , and send it and any supporting documents by encrypted email to [email protected].