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Co pay

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kwardbilling:
I'm also in the mental health billing field, and I do the same.  Call to verify information for copays etc I bill the patient if they don't pay their copay at their visit, and stipulate that if it's different because of co insurances etc. we will re-bill the remaining balance.  Most times it's a set copay, but I'm finding lately their are more co-insurances.  Again,  I defnitley check the EOB for Patient Responsiblity.  I've been doing mental health billing for 3 years.  What state are you from?  I'm from MA

NuBiker:
I'm in Southern California - about 30 miles east of Los Angeles.
About 80 per cent of our patients are Blue Cross. Effective January 2010, their computer somehow mistakenly changed a whole bunch of patients to capitation. I have been getting form letters stating BX won't pay, to send the HCFA to a private medical group. I phoned BX, and they figured out the problem right away, and corrected it, but said my payments might not show up for 30-45 days. Ouch!!!
I am gonna have to get a cash advance on the boss' credit card to pay the office lease.
Has that ever happened to anyone else here?
Nu

kwardbilling:
no, but I had a weird thing happen with BCBS this past month.  With one of my counselors they put a hold on the account saying that something had been returned to them as undeliverable so they thought she was no longer at.  Nothing had changed, she never moved etc, so I called BCBS and they took the hold off her account, meanwhile, quite a few claims came back as denied because of address and I needed to re-submit, which had delayed her payments for this past cycle.  (LOL, they probably mailed her something incorrectly i.e. not enough postage or something)..anyway seems to be all set now.

PMRNC:
If you are billing mental health (or any specialty for that matter) it's best not to stumble at all. I suggest taking a course and getting yourself educated. You will not only be seeing more "coinsurance" but you will also be seeing denials stating "No mental health benefits" due to the new parity laws that took effect in 2010. Groups of 50 or more will have the ability to drop mental health benefits upon group renewal dates or open enrollment dates. Or you might also see that there is no more 50% plans, no limits on benefits, etc. In doing verifications as of 1/1/2010 it's suggested you get the group renewal date so you can inform the patient that upon that date they will need to find out if their group will be extending or deleting mental health benefits. These new federal parity laws were supposed to be put in place to make mental health benefits "FAIR" however the insurance companies have to make up for the loss by increasing premiums and employers are finding they can't or won't pay the premium increase.
While the basics of billing are sometimes learned by hands on.. it's federal and state regulations that you can't afford to "stumble" through.

NuBiker:
I have been through two billing courses, but still lack confidence. Some days I feel like I am reinventing the wheel, LOL.
I think what saves me, is we only have about 50 patients at any one time. So most of the work is repetitive.
I always seem to have three accounts that are behind - the insurance company is late in reimbursing us.

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