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Medical Billing Forum
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Alice Scott
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Michele
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Expenses incurred during lapse in coverage
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Topic: Expenses incurred during lapse in coverage (Read 6635 times)
abhilashanilkumar
Newbie
Posts: 1
Expenses incurred during lapse in coverage
«
on:
September 21, 2020, 01:55:03 PM »
Could you help some what does mean by "Expenses incurred during lapse in coverage" and how can i resolve this denial.
Thanks in Advance,
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Michele
Administrator
Hero Member
Posts: 5927
Re: Expenses incurred during lapse in coverage
«
Reply #1 on:
September 21, 2020, 10:36:17 PM »
It means the patient did not have coverage at the time of service. You must bill the patient.
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david
Newbie
Posts: 10
Re: Expenses incurred during lapse in coverage
«
Reply #2 on:
October 15, 2020, 08:40:47 AM »
its means required insurance is expired. Patient is responsible for outstanding balance.
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Nick D
Newbie
Posts: 40
Re: Expenses incurred during lapse in coverage
«
Reply #3 on:
October 19, 2020, 01:38:04 PM »
Quote from: Michele on September 21, 2020, 10:36:17 PM
It means the patient did not have coverage at the time of service. You must bill the patient.
Michelle,
If they try to recoup after a retro-termination. Do you refund the insurance the money or do you tell insurance company to contact patient? (ERISA question)
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Michele
Administrator
Hero Member
Posts: 5927
Re: Expenses incurred during lapse in coverage
«
Reply #4 on:
October 20, 2020, 12:15:57 PM »
According the the ACA it is illegal for insurance companies to do recisions unless the patient committed fraud or deliberately lied.
https://www.verywellhealth.com/health-insurance-rescission-2615206
However the issue is that if the provider participates with the insurance carrier they will just deduct it from future payments.
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Medical Billing Forum
Re: Expenses incurred during lapse in coverage
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Reply #4 on:
October 20, 2020, 12:15:57 PM »
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Re: Expenses incurred during lapse in coverage
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Medical Billing Forum
Re: Expenses incurred during lapse in coverage
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Reply #14 on:
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Medical Billing Forum
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Expenses incurred during lapse in coverage