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Billing Scenario

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melissa_2004:
Yes billed as normal.  Fee of $575.  EOB information below:

Billed= 575.00   
Allowed = 105.30
Applied to deductible = 0.00
Co-Ins = 31.59
Paid = 73.71
Adjust Amt = 469.70
Patient Balance = 31.59

Pay_My_Claims:

--- Quote from: Mainstream Services Inc. on July 16, 2010, 02:25:33 PM ---Yes billed as normal.  Fee of $575.  EOB information below:

Billed= 575.00   
Allowed = 105.30
Applied to deductible = 0.00
Co-Ins = 31.59
Paid = 73.71
Adjust Amt = 469.70
Patient Balance = 31.59


--- End quote ---

You owe the patient!!

melissa_2004:
My thoughts exactly but now the saga continues.  The office now wants to re-bill (send a corrected claim) to the insurance carrier at the discounted amount.  Still no confirmation on  a hardship agreement (written) with the patient.  I've requested a copy for my records.

PMRNC:

--- Quote ---My thoughts exactly but now the saga continues.  The office now wants to re-bill (send a corrected claim) to the insurance carrier at the discounted amount.  Still no confirmation on  a hardship agreement (written) with the patient.  I've requested a copy for my records.
--- End quote ---

NO can do and this should teach them a lesson!  There is no corrected claim..you billed your normal fee, though I must say that carriers allowance Bites!  Refund the patient. If you send a claim, the only difference is going to be you are going to show what patient paid, and it isn't going to matter, you are still going to owe the patient.

melissa_2004:
Thanks for the input!  It was tough standing my ground with this but the point has gotten across.

Linda,  I agree the allowance really sucks.  Seems that way for a majority of the carriers this office is par with.  The range for reimbursement is $169 and lower for a $575 fee. 

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