General Category > General Questions
Expenses incurred during lapse in coverage
abhilashanilkumar:
Could you help some what does mean by "Expenses incurred during lapse in coverage" and how can i resolve this denial.
Thanks in Advance,
Michele:
It means the patient did not have coverage at the time of service. You must bill the patient.
david:
its means required insurance is expired. Patient is responsible for outstanding balance.
Nick D:
--- 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.
--- End quote ---
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)
Michele:
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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