Waiving Patient Balances: What Every Healthcare Provider Needs to Know

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Patient financial responsibility has increased significantly over the past decade. As a result, healthcare organizations sometimes feel pressure to waive copays, deductibles, or coinsurance to support patients.

While this may seem compassionate, routine balance waivers can raise serious compliance, legal, and contractual concerns.

This webinar explores how patient balance waivers intersect with coding, billing, compliance, and revenue integrity, and helps healthcare professionals understand how to handle these situations responsibly.

Must Attend For
✓ All certified and non-certified coding practice professionals.
✓ All RCM professionals
• Understanding Patient Cost-Share Responsibilities

• Legal Risks of Routine Cost-Share Waivers

• Federal False Claims Act: Key Concepts and Penalties

• Anti-Kickback Statute and Financial Inducement Risks

• Differences Between Federal Programs and Commercial Health Plans

• Real-World Case Examples and Enforcement Trends

• Developing Compliant Policies and Best Practices
• Why Waiving Patient Cost-Share Responsibility Matters

• Federal False Claims Act: Liability and Penalties

• Anti-Kickback Statute: Compliance Considerations

• Federal Health Programs vs Commercial Health Plans

• Health Plan Sample Language

• Analysis of Legal Cases

• Professional Courtesy, Financial Hardship, and Prompt Payment Discounts

• Why Routine Waiving of Patient Cost-Share Is Risky

• Federal False Claims Act – Definition and Penalties
• Explain the importance of patient cost-sharing and why insurers require copays, coinsurance, and deductibles.

• Understand legal and compliance risks associated with routinely waiving patient balances.

• Describe how federal regulations such as the False Claims Act and Anti-Kickback Statute apply to cost-share waivers.

• Differentiate expectations between federal health programs and commercial insurance plans.

• Recognize common contract language in payer agreements related to patient responsibility.

• Evaluate real-world legal cases to understand enforcement trends and compliance risks.

• Identify appropriate situations where cost-share adjustments may be permitted, such as financial hardship or prompt payment discounts.

• Develop practical strategies and internal policies that help organizations manage patient balances in a compliant manner.

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Presenter

Adilakshmi Sankara CPC, CIC, CPMA, CRC, CASCC

CPC, CIC, CPMA, CRC, CASCC

Adilakshmi Sankara is an accomplished healthcare revenue cycle leader with more than 29 years of expertise in Medical Coding Operations, Quality, Compliance, and Training. Renowned for driving medical coding excellence across multi-specialty settings, She bring deep experience in optimizing workflows, strengthening audit readiness, and elevating documentation and coding quality for global healthcare organizations. Her career spans work with U.S., UAE, KSA, and Indian healthcare systems, where she  has led high-performing teams, developed enterprise-wide training programs, and implemented scalable process improvements rooted in data-driven insights.

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