Health Care Claims Disputes: Patient Self-Pay

This segment comprises a minimal amount of the revenue stream for most hospitals. It arises from two primary sources:

1. Services provided to patients without any insurance and
2. Patient deductibles and coinsurance obligations incurred as a by product of providing services under a third-party payor arrangement.

Under ACA, the first of these two obligations will diminish since more patients will have insurance as they seek medical services. 

And, ACA is likely to drive the second of these upwards as more people are covered under expanded Medicaid and subsidized insurance plans and will thus be exposed to deductibles and coinsurance.

However, neither will be a new source of claims recovery.  And since collection of these amounts after admissions is typically difficult, increased emphasis on up-front collection of any required deductibles and arrangement for payment of patient coinsurances will be reqiured to avoid an increase in self-pay receivables.