Copay Adjustment

[Sivakumar]

Hi Guys,

Could you please clarify, whether shall we bill the initial visit copay to the patient if the claim has denied for untimely filing. Few of my staff suggest to bill the patient because it's the only prophet for our provider and others suggested to write-off since we crossed the limit to file the claim. Please advise.

Payer - United Healthcare

Thank You!!

[rdmoore2003]

look at your contract.....

[PMRNC]

look at your contract.....

Ditto, but I can tell you most won't allow for it. The ones that do, be prepared for the patient to put up a fight if the claim was never submitted, that copay is a "cost sharing" provision of their policy. Your contract will tell you if you can or cannot bill the patient.

[Sivakumar]

Thanks for your valuable response..