Provider Collection Policy 

This Policy is also available in your Provider Manual.  

HNE recommends that the provider submit the bill to HNE prior to collecting any portion of a member’s deductible and/or coinsurance. If a provider wishes to collect prior to submitting a bill to HNE, we expect providers and members to coordinate mutually acceptable terms for collection of a member’s deductible and/or coinsurance obligations.  

In no event may a provider collect from an HNE member for an HNE covered service more than the member’s current estimated remaining deductible obligation as of the date of service.   

In the event that an amount in excess of member’s actual obligation is inadvertently collected, the provider or facility must promptly remit such excess amount to the member upon verification from the provider’s or facility’s EOP or member’s EOB. 

HNE supports the use of standardized disclosure and authorization forms to facilitate dialogue between providers and members regarding financial responsibility and to establish expectations and facilitate collection of member deductible and/or coinsurance payments.  In all cases, HNE expects providers or facilities to apply collection practices that are no more restrictive to HNE members than those applied to members of any other commercial payers.