2009 008 Ordinance - Laserfiche WebLink

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automatically adjust Resident accounts according to this Resident collection policy and provide Client with a listing of these accounts each month. b. Resident Receipt of Payments from Payors. If Life Force becomes aware that a Resident received payment directly from a Payor, Life Force will send monthly statements and attempt to collect until Life Force receives the amount from the Resident. After receiving the total amount paid to the Resident, Life Force will waive the remaining balance. If a Resident does not pay the total amount.of the insurance payment, Life Force will notify Client for direction on the next appropriate action to take. Life Force will flag these accounts separately for Client's review as necessary. DELINQUENT ACCOUNTS ELECTIONS Pursuant to Section 2(H), Client shall notify Life Force, in writing, of any assignments and all contractual discounts, non-chargeable services, write-offs, and other similar discounts which impact patient billing. Delinquent Accounts are accounts that are unpaid after 120 days in "private pay" and Life Force has expended its usual and customary efforts with respect to billing and collecting. Client may require Life Force to continue billing Delinquent Accounts on a case by case basis for additional reasonable periods of time. Financial Hardship waivers are reductions and waivers of the patient responsibility based on information from the individual on income and/or assets (e.g., the Federal Poverty Income Guidelines to establish poverty levels). In addition to Client's election on Resident Responsible Party billing in Section 4 of this Appendix to the Agreement, Client also authorizes Life Force to write off Delinquent Accounts as follows: AUTHORIZED LIAISON REVIEW AND WRITE OFF OPTIONS: _X_ Life Force shall submit Delinquent Accounts to the Client for an individ al review and determination of write off as non-collectible. Client hereby author z Life Force to write off Delinquent Accounts as not collectible only with wri en ? authority from Authorized Liaison. Client hereby authorizes Life Force to refer Delinquent Accounts to a collection agency designated by Client only with written authority from Authorized Liaison. LIFE FORCE WRITE OFF OPTIONS: Client hereby authorizes Life Force to write-off Delinquent Accounts as not collectible without a formal review by or written authority from Client. All supporting documentation regarding the action taken by Life Force staff will be kept on file by the date the action took place for review or auditing purposes. Life Force may refer Delinquent Accounts to a collection agency designated by Client without written authority. 22068/513664-1 CUSTOMER NAME: DATE: