Medical Billing Forum

Billing => Billing => : carnilent May 22, 2009, 05:34:37 PM

: billing hmos
: carnilent May 22, 2009, 05:34:37 PM

Good Afternoon to all;


when a patient pays their co pay does the balance get billed to the hmo insurance?



( I know that doctors get a lump sum check every month for each patient on his hmo insurance list )

  ???

thanks for responding,

Carnilent 

: Re: billing hmos
: Pay_My_Claims May 22, 2009, 06:20:40 PM

Yes it is billed to insurance.

: Re: billing hmos
: PMRNC May 22, 2009, 07:03:57 PM

Not all HMO's require a claim, you have to check with each one. It's also a good idea to keep a list or keep track of how each one processes claims or else payment posting gets a little confusing!

: Re: billing hmos
: carnilent May 22, 2009, 07:41:29 PM

thank you.

What about the Doctors that get a lump sum monthly check?   

Does the patient still pay a copay?   



thanks again,

Carnilent

: Re: billing hmos
: PMRNC May 23, 2009, 12:36:15 PM

No, generally unless they are seen they don't pay a copay for an HMO. Though you will run across a few HMO's you won't see them as much as you would have a few years ago.
When the check comes in you will still need to post to the accounts and like I said.. some will require a claim every month, some won't. Special posting codes are recommended in your PM software so you can report on HMO's montly or bi-monthly because they really have to be watched carefully.