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Getting Paid from HSAs Can be Perilous
January 1, 2008
Most provider organizations still do not know how to handle payment arrangements for patients with a health savings account, says consultant Steven Lazarus.
During the HIMSS Conference, Lazarus, president at Denver-based Boundary Information Group, will co-host an educational session to lay out the landscape of the HSA world. And it's one filled with minefields, he cautions. "A lot of the ramifications of these plans are not good."
For example, one major insurer has implemented a debit card-supported HSA program. But when providers swipe the card for a $100 charge, they aren't immediately getting paid $100; that money is put on hold in the patient's account. "But you don't know that, and your patient doesn't know that, and your billing system isn't set up to handle it," Lazarus says. Another example: Many HSA plans have arrangements with banks so when a claim gets adjudicated the plans have permission to withdraw the patient's payment from the HSA account.
If there isn't enough money in the account, the provider doesn't get paid. If the provider gets paid, the payment comes from the insurer so it looks like a health plan payment and the provider might mistakenly bill the patient for any remaining amounts, Lazarus says.
Session #108, "HSAs Spell Bad Debt or Change for You?" will detail business process changes and tools necessary to deal with HSAs, Lazarus says. The session will be held Tuesday, Feb. 26, at 2:15 p.m. in Room 300w of the Orange County Convention Center.
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