Mayo Clinic

Mayo Clinic: EMTALA and Collections Policies

Amanda Stammer
Kathryn Stuhler
Thomas Van Towle
Christina Vidrich
Business Skills for Health Care
26 April 2015

Mayo Clinic

The Mayo Clinic is the largest integrated, non-profit hospital in the world. It serves
patients from more than 143 countries, and its mission is, To inspire hope and contribute to
health and well-being by providing the best care to every patient through integrated clinical
practice, education and research (Mayo Clinic, 2012. The Mayo Clinic has multiple campuses
in Minnesota, Florida, and Arizona serving more than seventy communities in the Upper
Midwest (Mayo Clinic, 2012).
Following are policy guidelines and for the emergency department and also for billing
and collections.

Policy Guidelines for Mayo Clinic Hospital

POLICY NAME: Emergency Medical Treatment & Labor Act (EMTALA)
PURPOSE:
To provide safe quality care for patients and ensure compliance. The Emergency Medical
Treatment & Labor Act (EMTALA) was established in 1986 and provides the public the right to
be treated by emergency services for an emergency medical condition regardless of their ability
to pay. The Social Security Act ensures hospitals that are Medicare-participating to medically
treat patients including laboring mothers. The statue does not limit Medicare patients; the law
included any patients with the inability to pay for treatment, to be treated. Our facility will
assess and treat all patients requiring emergency medical treatment care with an appropriate
medical screening examination (MSE) (Centers for Medicare & Medicaid, 2012).
SCOPE:
All nursing, patient care staff, anesthesia, and medical staff.

Mayo Clinic

POLICY:
Any emergency medical condition (including severe pain) that requires immediate medical
attention and places the patient (or unborn child) in serious medical jeopardy, or there is
inadequate time to transfer a mother in labor to another facility will be treated with the upmost
care and respect (Fosmire, 2009). Misrepresentation of the patients conditions is punishable
under the law. The transfer of an individual shall not consider ethnicity, race, religion, national
origin, age, sex, sexual orientation, pre-existing medical condition, physical or mental handicap,
citizenship, insurance status, economic status or ability to pay for medical services except to the
extent that pre-existing medical condition or physical or mental handicap is significant to the
provision of appropriate medical care to the individual (HCA Management Services, 2015).
Our hospital will receive patients from transferring facilities who are unable to treat the patient
so long as our hospital has he capabilities to do so.
PROCEDURE:
The patient has the right to seek treatment for emergency medical conditions. Our physicians,
including on call physicians, will be responsible to examine and treat patients presenting with
any emergency medical condition. The patient will be informed of the risks and benefits of the
treatment our facility has offered. The patient, or their designee, can refuse to consent to the
treatments or request to transfer to another facility in writing. The physician will advise the
patient of the hospital's EMTALA obligations, and of the risk of transferring to another facility
(Fosmire, 2009).
PATIENT EDUCATION:
It is imperative to educate the patient about their rights and responsibilities of treatment or
refusal of treatment. The patient, or designee, will be educated on their condition and benefits as

Mayo Clinic

appropriate. Our facility will provide a visual sign to educate patients on their rights such as:
If you have a medical emergency or are in labor, even if you cannot pay or do not have
medical insurance or you are not entitled to Medicare or Medicaid, you have the right to receive,
within the capabilities of this hospitals staff and facilities:

An appropriate medical screening examination;

Necessary stabilizing treatment (including treatment for an unborn child), if necessary; and

An appropriate transfer to another facility.

This hospital (does/does not) participate in the Medicaid program (HCA Management Services,
2015).

Mayo Clinic Hospital Billing and Collections Policy

EFFECTIVE DATE: 4/22/15
MISSION:
The Mayo Clinic mission is, To inspire hope and contribute to health and well-being by
providing the best care to every patient through integrated clinical practice, education and
research (Mayo Clinic, 2015).
POLICY PURPOSE:
This policy is intended to meet state, federal, and local laws for hospital billing and collections.
This policy outlines the actions taken by Mayo Clinic for both billing and collections. This
policy is for all Mayo Clinic Rochester, Minnesota locations (Temple University Hospital, 2014).
MAYO CLINICS COMMITMENTS:

Serve all emergency care patients regardless of ability to pay. (See EMTALA policy)

Treat all patients with dignity and respect

Mayo Clinic

Assist patients who cant pay for part of or all of our services.

Provide prompt financial advising.

(American Hospital Association, 2012)

FAIR PRICING:
Mayo Clinic holds itself to the highest ethical standards. As a non-profit organization we are
committed to fair pricing. No uninsured patient will be charged at a rate higher than those
patients with insurance (Internal Revenue Service, 2015).
BILLING PROCEDURE:

Mayo Clinic will request all required that portions of patient responsible payments prior to nonemergent care. All emergent care payment will be requested following care (Temple University
Hospital, 2014).

If the patient qualifies for charity care, after third party payment is collected all further cost will
be written off. The patient will not be responsible for the balance (Temple University Hospital,
2014).

For all payment not received prior to care, a bill will be issued to the patient following third
payer payment (Temple University Hospital, 2014).

If patient is not received in 45 days of the postmark on the bill, a reminder bill will be issued.
COLLECTIONS PROCESS:

If payment has not been received 90 days following the first bill, the Mayo Clinic will make
effort to contact the patient by a call from a financial advisor and one final bill with final notice.

If a bill hasnt been paid after 135 days, it will be eligible to be turned into a third party
collection agency of Mayo Clinics discretion.
FINANCIAL ASSISTANCE:

Mayo Clinic

Mayo Clinic is committed to the highest quality care and is driven to not allow a patients fear of
a bill to prevent a patient from receiving essential health services (New Jersey Hospital
Association, 2014).
1. Financial advisors are available between 8am-5pm Monday thru Friday and by appointment.
The Financial Advisors office can be reached at 945-445-9900. More information can be found
on your Finance Advisor Webpage. www.mayoclinic/fiancial advisors.com
2. Prior to the end of 135 days post billing, the patient can apply for charity care or financial
assistance.
3. Mayo Clinics Financial Aide and Charitable Care Policy can be located at
http://www.mayoclinic.org/documents/charitable-care-and-financial-assistance-policy/doc20079439. Our Financial advisors are trained and available to assist you with understanding this
policy (Mayo Clinic, 2012).

With these policies in place, patients will have a better understanding of their rights and
what to expect from Mayo Clinic. It will also help employees have set guidelines to follow and
policies to refer back to. A clear concise foundation can help improve patient care and patient
satisfaction.

References
American Hospital Association. (2012). Hospital billing and collection practices statement of
principles and guidelines. Retrieved from http://www.aha.org/advocacy-

Mayo Clinic

issues/bcc/index.shtml
Centers for Medicare & Medicaid. (2012). Emergency medical treatment & labor act.
(EMTALA). Retrieved from http://www.cms.gov/EMTALA/
HCA Management Services. (2015). EMTALA facility sample policies. Retrieved from
http://hcaethics.com/policies/emtala- facility-policies.dot
Fosmire, M. (2009). FAQ on EMTALA. Retrieved from http://www.emtala.com/faq.htm
Internal Revenue Service. (2015). New requirements for 503(C) hospitals under Affordable Car
Act. Retrieved from http://www.irs.gov/Charities-&-Non-Profits/CharitableOrganizations/New-Requirements-for-501(c)(3)-Hospitals-Under-the-Affordable-CareAct
Mayo Clinic. (2015). Mayo Clinic mission and values. Retrieved from
http://www.mayoclinic.org/about-mayo-clinic/mission-values
Mayo Clinic. (2012). Charity care policy - Administration of financial assistance. Retrieved
from http://www.mayoclinic.org/documents/charitable-care-and-financial-assistancepolicy/doc-20079439
Mayo Clinic. (2012). Facts and highlights. Retrieved from
http://www.mayoclinic.org/documents/mc2045-pdf/doc-20078949
New Jersey Hospital Association. (2014). Statement of principles and guidelines for hospital
billing and collection process. Retrieved from www.aha.org/newjerseyguidelines.pdf
Temple University Hospital. (2014). Billing and collection policy. Retrieved from
http://tuh.templehealth.org/content/upload/AssetMgmt/Documents/TUH%20Billing%20a
nd%20Collections%20Policy%207-1-2014.pdf