Medical Billing Forum

General Category => General Questions => Topic started by: spinalhealth on April 08, 2013, 05:43:24 PM

Title: billing for services we KNOW are not covered
Post by: spinalhealth on April 08, 2013, 05:43:24 PM
general question:

if a patient comes in and has a service during the course of a visit that we know is not covered by an insurance plan (i.e., venipuncture, oximetry, etc) do we legally have to bill that service and write it off when the insurance denies it or can we just skip billing it all together?

any info would be VERY appreciated -- thank you !!
Title: Re: billing for services we KNOW are not covered
Post by: DMK on April 08, 2013, 06:36:40 PM
I believe you have to bill for everything done, but even if it's non-covered you shouldn't have to write it off if you've notified the patient that is non-covered.  The exception would be if your contract with the insurance company says you can't charge for non-covered item.

I just got a letter today, in fact, from Cigna saying we can only charge the patient for co-pays, co-insurance, and deductibles UNLESS we notify the patient that certain things will not be covered.
Title: Re: billing for services we KNOW are not covered
Post by: PMRNC on April 09, 2013, 03:06:40 PM
Don't forget if it's Medicare you want to be sure you have looked at requirements for the ABN.