Payments > Patient Billing

ABN FOR COMMERCIAL INSURANCE?

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cturner:
Hi,
Can we have patients sign an ABN form for Insurances other than Medicare?  What about Medicare Replacements?
Thanks!
cturner

Michele:
Hi,
   I would use the ABN for the Medicare HMO's but I would make a new form for other insurances and use the ABN format but take out the 'Medicares'. 
Michele

cturner:
Thanks!
Yes, we have an ABN form for Insurances other than Medicare (as well as one just for Medicare).  We had a patient sign an ABN for a procedure that we know is not covered by his Insurance, we billed the Insurance & they denied payment, so we then billed the patient.  He contacted his Insurance & his Insurance company told him that what we were doing was illegal.  He told him we were "balance billing".  I just wanted to make sure we were doing this correctly.
Thanks,
cturner

Michele:
Hi,
   I just wanted to make sure I cleared up one thing.  If you are a participating provider with the insurance carrier, you need to make sure that it's a service that they allow you to bill the patient for.  Most insurances (if they don't allow for a service) do allow the provider to bill the patient, but you should double check.  The EOB with the denial should indicate if the patient can be billed.

Michele

cturner:
Hi,
   We are a participating provider with the Insurance carrier.  The procedure we billed was denied, as it always is, however the ABN we had the Patient sign stated that their Insurance would not pay for the procedure & that they would be responsible for payment.  Don't we have a right to bill when we have advised the patient in writing prior to the service being performed?
Thanks

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