CareCentrix's Sofiane offers details on PAP policy

CareCentrix recently implemented a new policy in an effort to reduce the number of PAP patients with past due balances of more than 180 days. Hailey Sofiane, senior vice president of operations, performance optimization, recently provided some clarification on the new policy in an email to HME News.

HME NEWS: Why was this policy necessary to put into place?

Hailey Sofiane: Occasionally, CareCentrix does not receive payment (or a method of payment) for services or supplies delivered by our provider network. We offer and encourage patients to provide a method of payment upfront for services to avoid going into arrears. Our team will attempt multiple times to reach a patient in arrears via various forms of communication, including phone calls and letters, to collect payment. We offer flexible options, including 18-month, interest-free repayment plans, for our more than 26 million members across the country.

HME: Is there a large number of patients at 180 days or more?

Sofiane: No. On the occasions we don't receive payment for services, we make every effort to work out a solution. We follow up with written notices and phone calls at different times and days of the week. After six months, if CareCentrix does not hear from a patient, as a last resort, we ask the provider to temporarily pause non-life-sustaining services until a payment arrangement is made.

HME: Are providers concerned about being "caught in the middle”?

Sofiane: This policy was developed with feedback and input from our providers. As part of normal business (and prior to this policy), our providers refer their patients to CareCentrix regarding patient billing questions or concerns. At least 60 days advance notice of any pause in service—while we attempt to collect on the aged outstanding balance—is provided to both the provider and patient. Claims payment will only be at-risk should a provider continue to render PAP services to a patient after the temporary pause effective date. The policy applies only to non-life-sustaining services, and it is not the intention to delay service to any patient. Once a return call is made to CareCentrix and payment arrangements are agreed upon, service will continue immediately.