Yes, as long as the patient is not seeing you based on a referral from an emergency department (ED) where you were on call when the patient was seen. If that is the case, determine the hospital’s requirements as established in its medical staff bylaws and rules and regulations. You must follow those requirements.
At a minimum, it is likely you will be required to see the patient at least one time to determine status and whether the patient has an emergency medical condition that qualifies under the Emergency Medical Treatment and Labor Act. If the patient needs emergent treatment, you will likely be required to provide care regardless of the ability to pay, although you can ask for payment or payment arrangements.
If the patient did not come to you as a result of ED call coverage and you have an established policy of not accepting patients who cannot pay, you can refuse to establish the relationship. Give potential patients some indication of your practice’s financial requirements when they make an initial appointment for treatment. In addition, posting a notification on your practice website helps communicate the policy and avoid any subsequent disputes or misunderstandings.
Potential patients who are not aware of your financial requirements may delay making other care arrangements while waiting for an appointment with you. If the patient then arrives for an appointment and you decide not to accept him or her for financial reasons, your decision may appear questionable if the patient is injured by the subsequent delay in receiving care.
Having the biller check the status of coverage before a patient arrives for an appointment can expedite your decision about whether to accept an individual as your patient.
Consider including a disclaimer regarding the provider-patient relationship on the practice website and on data collection tools (e.g., preliminary healthcare and insurance questionnaires). The disclaimer should state that the practice does not deem an individual seeking treatment to be a patient until a preliminary assessment is concluded and the individual has been notified about being accepted as a patient. Similarly, advise prospective patients at the outset that simply making an appointment or returning a completed health questionnaire does not automatically trigger the relationship.