Author Topic: Timely Filing Denial and patient copay  (Read 7594 times)

shannon29073

  • Newbie
  • *
  • Posts: 2
Timely Filing Denial and patient copay
« on: June 07, 2009, 10:03:11 PM »
When the claim denies for timely filing and it is the providers fault- Do you have to refund the patient's copay?

Since the provider didn't follow the guidelines set forth in their contract- Is the patient still responsible for the copay?

Thanks!

Pay_My_Claims

  • Guest
Re: Timely Filing Denial and patient copay
« Reply #1 on: June 07, 2009, 10:44:12 PM »
We wouldn't "refund" we would just credit the account. I had a couple of those when I started at a new practice, and I had to review the current AR. Most providers don't like to refund, but thats a totally different post. Now, I can tell you if you are non-par, they will deny with patient responsible, but it doesn't mean you will get paid!! We get denials from case management who don't get PPA on medicare 2ndary policies and we are non-par and it will have patient responsible, because the guidelines for par and non par are different.

PMRNC

  • Hero Member
  • *****
  • Posts: 4562
    • One Stop Resources & Networking for Medical Billers
Re: Timely Filing Denial and patient copay
« Reply #2 on: June 08, 2009, 09:31:52 AM »
It depends on the contract, some managed care contracts will allow you to collect the copay meeting only the guideline that "Services were rendered" In most contracts I've seen it's specified.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

shannon29073

  • Newbie
  • *
  • Posts: 2
Re: Timely Filing Denial and patient copay
« Reply #3 on: June 08, 2009, 10:02:21 AM »
We are in network with all of the carriers. I will have to pull all of the carrier manuals that we have. Thanks for your help. There is a huge difference of opinion between my staff. Most say we provided the services we should at least be able to keep the copay. The rest feel that we didn't abide by our contract therefore we shouldn't even get to keep the copay.

Trying to find something "concrete"- one way or the other!!

Thanks Again! I am excited that I found you!

PMRNC

  • Hero Member
  • *****
  • Posts: 4562
    • One Stop Resources & Networking for Medical Billers
Re: Timely Filing Denial and patient copay
« Reply #4 on: June 08, 2009, 10:24:38 AM »
Yes, you have to go through each contract to see what the rules are.
What I do with my clients is I actually go through all their par contracts and I use a single sheet form to list certain notes for each one so that I have a quick reference. 
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Medical Billing Forum

Re: Timely Filing Denial and patient copay
« Reply #4 on: June 08, 2009, 10:24:38 AM »

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: Timely Filing Denial and patient copay
« Reply #5 on: June 08, 2009, 11:29:07 PM »
If you have a provider rep you can always give them a call, if you can't locate it in the manual.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

unorgobug

  • Sr. Member
  • ****
  • Posts: 330
    • doxycycline ruined my life
Re: Timely Filing Denial and patient copay
« Reply #6 on: November 14, 2022, 06:39:55 PM »
Is it hot in here or is it just me <a href=https://doxycycline.world/>doxycycline alternatives</a> Replacement of specific patient terms

jossibe

  • Full Member
  • ***
  • Posts: 247
    • stromectol ivermectin tablets
Re: Timely Filing Denial and patient copay
« Reply #7 on: November 16, 2022, 04:51:37 AM »
Given exact time to return to gate for boarding <a href=http://stromectol.ink/>stromectol otc</a> vermox metronidazole injeksi dosis If the debt ceiling is not raised, it added, our calculations suggest that the OECD region as a whole will be pushed back into recession next year, and emerging economies will experience a sharp slowdown

royagma

  • Sr. Member
  • ****
  • Posts: 326
    • generic of furosemide bad for your kidneys
Re: Timely Filing Denial and patient copay
« Reply #8 on: November 16, 2022, 10:41:06 AM »
<a href=http://lasix.autos/>lasix for dogs</a> Am J Obstet Gynecol 170 818 823, 1994

Vogegrorb

  • Sr. Member
  • ****
  • Posts: 334
    • is levitra still on the market
Re: Timely Filing Denial and patient copay
« Reply #9 on: December 08, 2022, 11:04:13 AM »
The absorbance was recorded at 550 nm using an ELISA reader <a href=https://clevitras.cyou>cialis levitra ou viagra en ligne</a> Their clinical histories were obtained from administrative data including their prior use of hormone replacement therapy and whether they had received radiation or adjuvant chemotherapy

Medical Billing Forum

Re: Timely Filing Denial and patient copay
« Reply #9 on: December 08, 2022, 11:04:13 AM »

piegmen

  • Sr. Member
  • ****
  • Posts: 326
    • durjoy dapoxetine hcl
Re: Timely Filing Denial and patient copay
« Reply #10 on: December 09, 2022, 03:40:22 PM »
<a href=http://lasix.one>lasix over the counter cvs</a> Healthcare providers may also prescribe citalopram off label to treat other mental health conditions

awaixebra

  • Full Member
  • ***
  • Posts: 239
    • taking 2 cialis pills at once
Re: Timely Filing Denial and patient copay
« Reply #11 on: December 12, 2022, 03:43:58 AM »
zeagra efeitos colaterais yasmin 21 7 Unilever, the 14th biggest company in the FTSE 100, fell 3 <a href=https://propecia.hair>finax for sale</a> ETV4 and AP1 transcription factors form multivalent interactions with three sites on the MED25 activator interacting domain

lapound

  • Sr. Member
  • ****
  • Posts: 340
    • do you have to use finasteride forever
Re: Timely Filing Denial and patient copay
« Reply #12 on: December 19, 2022, 09:40:21 PM »
<a href=https://clevitras.monster>commander levitra original</a> tamsulosin analgin dimedrol pri beremennosti Ultimately, the battle for Syria s future boils down to identity, whether Syrian society is by nature religious or secular, and how either identity might be represented by whatever replaces the stifling Baath Party

Faispom

  • Sr. Member
  • ****
  • Posts: 322
    • cialis time to be effective
Re: Timely Filing Denial and patient copay
« Reply #13 on: January 25, 2023, 11:53:49 AM »
erythema Erythema Redness of the skin produced by congestion of the capillaries <a href=https://cialis.makeup>purchase cialis online</a> com 20 E2 AD 90 20Viagra 20Femenino 20Nombre 20Comercial 20Mexico 20 20Tem 20Viagra 20Em 20Gotas tem viagra em gotas Apple s entry into the emerging smartwatch category will have tech tongues wagging

ideorrert

  • Sr. Member
  • ****
  • Posts: 304
    • liquid clomiphene dosage
Re: Timely Filing Denial and patient copay
« Reply #14 on: February 02, 2023, 05:37:26 AM »
<a href=https://lasix.beauty>how much potassium for 20 mg lasix</a> Obstet Gynecol 2006; 107 337 341

Medical Billing Forum

Re: Timely Filing Denial and patient copay
« Reply #14 on: February 02, 2023, 05:37:26 AM »