Payments > Insurance Payments
Balance Billing
kristin:
It has been years since I have dealt with billing an out of network insurance for a patient, so I have a question...why bill the insurance at all, if not contracted with them? Isn't that just a courtesy to the patient? Why not collect payment in full at TOS, give the patient a receipt, and let them file a claim on their own, to recoup back what they can, if anything? Or is that not allowed anymore?
rdmoore2003:
When filing the claim, are you "accepting assignment of benefits"? This can cause an issue with an out of network plan.
PMRNC:
--- Quote ---When filing the claim, are you "accepting assignment of benefits"? This can cause an issue with an out of network plan.
--- End quote ---
Especially BCBS, in most states they don't honor assignment of benefits for out of network providers.
mindy167:
F/U to PMRNC response 08/04/2016 -sorry for delay!
Yes, AOB and have since received info bills processed under emergency care which this insurance will process as in-network even if no contract exists.
Yes, there was an allowable and a not covered portion.
What recourse, if any, can be done to receive the balance due?
Michele:
If no contract exists then the provider can bill for the entire billed amount minus any payment made. So even though they processed as in network, with the absence of a contract the patient is responsible for the entire amount if that is what the provider wishes to do.
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