Author Topic: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE  (Read 2455 times)

Mack753

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COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« on: March 17, 2012, 05:44:12 PM »
Hello!  I hope someone can help me.  I manage a chiropractic office and cannot find any information regarding how to calculate interest on personal injury claims that are being paid late.  We are located in Pennsylvania.  I have searched the internet but as of yet can't find the answer.  Thank you!

PMRNC

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Re: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« Reply #1 on: March 18, 2012, 10:23:06 AM »
I'm assuming you mean interest to the insurance carriers? You don't charge it, they will pay it according to contract and/or state law. Interest is not automatically due for all payments "paid beyond the limitations", the carriers in most cases only have to "pend" or "consider" with explanation to the delay to avoid any interest.  You would send your claims as normal and if any interest is legally due it will be calculated.
Linda Walker
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AdvancedSpine

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Re: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« Reply #2 on: March 20, 2012, 05:45:12 PM »
Check your Pa Statutes.  I found this:

Title 40, [section]991.2166 of Pennsylvania Statutes, entitled "Prompt Payment of Claims," provides that

(a) A licensed insurer or a managed care plan shall pay a clean claim submitted by a health care provider within forty-five (45) days of receipt of the clean claim. (2)

(b) If a licensed insurer or a managed care plan fails to remit the payment as provided under subsection (a), interest at ten per centum (10%) per annum shall be added to the amount owed on the clean claim.




PMRNC

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Re: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« Reply #3 on: March 22, 2012, 11:28:31 AM »
Quote
Check your Pa Statutes.  I found this:

Title 40, [section]991.2166 of Pennsylvania Statutes, entitled "Prompt Payment of Claims," provides that

(a) A licensed insurer or a managed care plan shall pay a clean claim submitted by a health care provider within forty-five (45) days of receipt of the clean claim. (2)

(b) If a licensed insurer or a managed care plan fails to remit the payment as provided under subsection (a), interest at ten per centum (10%) per annum shall be added to the amount owed on the clean claim.

Correct, but clean claim has it's own meaning.. clean claim means.. no pending, no further info needed, no review, .. completely clean and they pay or deny.  PI cases are very very rarely clean upon submission, if the carrier pends the claim for further info or review, etc the claim is not interest payable at that time until the clock begins to tick again.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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Re: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« Reply #4 on: March 22, 2012, 11:53:15 AM »
This probably answered the question I just posted (except I'm in California).  So I'm screwed.

AdvancedSpine

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Re: COLLECTING INTEREST ON PI CLAIMS OVER 30 DAYS LATE
« Reply #5 on: March 28, 2012, 10:13:04 AM »
Linda, you're right.  I meant to add that I never really count on any interest for claims paid late but I know about the interest mainly because sometimes I have to reconcile the inurance payments and they have interest and penalty added.  The EOBs are not always included so it forced me to look for the info on some of my cases.