Medical Billing Forum

Payments => Patient Billing => Topic started by: RSI on November 01, 2015, 08:39:08 AM

Title: Billing Pt. Responsibility Amount when primary insurance denies/Timely Filing
Post by: RSI on November 01, 2015, 08:39:08 AM
Hi There,

Fairly new to billing for private physicians.

Patient has primary and secondary insurance. In network for both. I submitted a claim to primary insurance - Aetna - and it returned denied for timely filing. Sent claim to Medicare as secondary and ERA returned stating patient responsibility was $18.89.  I want to confirm the patient should be billed for 18.89.   

Thanks for you input.
Title: Re: Billing Pt. Responsibility Amount when primary insurance denies/Timely Filing
Post by: Michele on November 02, 2015, 11:19:22 AM
This is a tricky question because due to the timely filing denial by Aetna you should not charge the patient, however, with the patient having Medicare secondary and they did make patient, Medicare is stating you can bill the patient the $18.89.  So I believe that you can bill the patient the $18.89 based on the Medicare payment.
Title: Re: Billing Pt. Responsibility Amount when primary insurance denies/Timely Filing
Post by: adnanqamar on March 05, 2016, 07:42:46 AM
Yes, you can bill to patient.