Author Topic: Billing by years end  (Read 1976 times)

Angie

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Billing by years end
« on: December 28, 2011, 03:33:25 PM »
We are a private pay facility and provide our patients with a super bill (itemized statement) after the program has been completed if they request one because often times they like to try to submit some of it to their insurance to see if they can get some reimbursement.  (we are a wilderness program which most insurance companies will not pay for)
I have alot of patients calling in a panic stating that they need to submit everything to their insurance before the end of the year or they will not be able to get any reimbursement. Don't they have a timely filing period, not by the end of the year? And any services rendered in 2011 goes toward their 2011 deductible, benefit regardless if it is submitted in 2012?
This is for insurance, not flex spending or HSA ect....
I'm pretty sure I know the answer to this questions but just need to clarify.
Thanks.

PMRNC

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Re: Billing by years end
« Reply #1 on: December 28, 2011, 06:52:23 PM »
Since you are a self-pay facility your patient's should be receiving a financial policy to sign which tells them up front your billing policies as well as a blanket disclosure that the services you provide may/may not be covered by insurance company. . That would be the first thing.  They should already be aware that insurance reimbursement is between them and their insurance companies. IF this information is NOT provided to them upfront, you can't blame them for seeking the correct billing to send on to seek reimbursement.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Angie

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Re: Billing by years end
« Reply #2 on: December 29, 2011, 08:24:35 AM »
It is provided to them upfront in writing and verbally and they are very aware it is self pay; payment is always collected in full. They know that anything that they may get from their insurance company is only going to be reimbursement and that we can only provide them with a super bill for them to battle it out with their insurance.
Most times they will have misplaced the superbill or never have requested one and then suddenly this week are calling in a frantic saying they need to get it to their insurance before the end of the year or they are not going to be able to get reimbursed because it was not turned into the insurance in 2011.
So my question was: Am I correct that if they turn it into their insurance within their timely filing period even if it is in 2012 and the services were rendered in 2011; they can still seek reimbursed regardless if the services were rendered this year depending on their benefits? (say they discharged 12/31 and we wont be able to provide them with the superbill until next week 2012; it is only for 3 weeks of services)
Also even if they submit it to their insurance in 2012 any services provided in 2011 goes toward their 2011 deductible/ benefits, correct? regardless when they submit it 2011 or 2012?
Thanks Linda

PMRNC

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Re: Billing by years end
« Reply #3 on: December 31, 2011, 11:26:39 AM »
You have covered all your basis, you are not required to do any more than what you are doing. You can remind the patient of the disclaimer they received upon initiating treatment and tell them what you have provided is all that can be provided.   
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com