Incurring administrative fees for the privilege of being billed at a later date should be a key part of an enrollment briefing if it applies in a particular network. These administrative fees, in addition to required copayments, could affect these families the most. Contracts will not be modified to disallow collection of administrative fees because elimination of billing and its attendant costs is a key feature of managed care. It is industry practice to collect visit fees at the time of service is rendered and to collect administrative fees if beneficiaries elect to be billed. Prohibiting this practice could increase overall costs to the government since enrollees, absent any incentive to pay at the time services are rendered, may choose to delay payment more often, thereby incurring additional costs of billing by HMOs and individual providers.
Beneficiaries have the right to know their options to pay required copayments.
They should be told that they can pay be cash, check, or credit card, and if delayed payment will result in an administrative charge. In addition, administrative fees may impact some families enrolled with civilian primary care managers. Every effort should be placed on enrolling families of E-4 and below in MTFs where most copayments are not required.