Billing > Billing

EAP

<< < (2/3) > >>

gderilus:
how do you manage EAP patients and A/R. Do you also use Practice Management software as if you were doing regular medical billing. Also, do u get EOB's from the EAP companies when you receive payments.

PMRNC:
Yes, you should still manage EAP cases within the same PM Software Database, but because of the really tough privacy issues with EAP I create a separate patient file with an identifier to mark it as EAP.

gderilus:
Do you have to go through denial and appeal process with EAP or do they always make full payments.

PMRNC:
Not usually, In fact I can't recall ever having to appeal. The only denials you might get are eligibility ones.. for example a patient might be covered at the time you verified benefits but maybe something happened in interim and they were not eligible, for those you just bill the patient. Sometimes you will see the EAP saying the patient was not EAP eligible and if that's the case you verify benefits with the major medical carrier or mental health benefits from back of the card and resubmit to them. But in terms of denials EAP USUALLY pays at 100%, occasionally some will have a small copay, but most pay at 100% of the contracted rate. They are only temp benefits. Once EAP is exhausted claims then go through major med or the MH carrier.They are separate benefits.

rdmoore2003:
Thanks   This is all new to me.  My MH providers are just now deciding to get in network with insurance carriers and they are concerned about the EAP's.   Thanks for the help

Navigation

[0] Message Index

[#] Next page

[*] Previous page