Hello,
Question regarding doing an ABN when precertification for services is only partially approved.
The situation is we requested 16 units for neuropsych testing, interpretation, report prep and pt. feedback. Insurance only approved 8 units.
In the past, we would just see the patient and take the hit, but this has been coming up more often.
Can we have the pt. sign a separate agreement stating something to the effect that insurance has only approved x number of units of service, to do a comprehensive evaluation, we will need to collect x amount of additional funds in addition to what insurance has approved for payment?
I just don't want this to be misconstrued as "balance billing." Also, should we go ahead and submit the additional 8 units to insurance anyway knowing it will be denied?
The company in question is Magellan of IL. I researched their provider handbook and they do not mention the above situation, only that balance billing for network providers is prohibited.
Any input would be greatly appreciated.
Thank you!