Medical Billing Forum
General Category => General Questions => : margemib August 25, 2009, 08:00:21 PM
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Hi Michele,
When sending out patient statements and the insurance co has not made a payment yet because it is still pending, do you have it set up not to reflect on the statements till after payments are made by ins co?
margemib
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Those are called "Anticipated Insurance Payments" and that is a preference. I only do it for my small clients that basically have a steady stream of insurance payments, for example for my mental health providers, we know pretty much what is coming in on certain accounts. If I send out claims for 4 therapy visits I will look at the chart, make a determination based on whether the patient paid their copay or not. If the patient did not pay any copay's I will post the "anticipated" payment and send out a statement so that we can collect the copay's. My own preference is to do this on a case-by case basis, some offices will do it based on benefit verifications and I don't feel safe with a new account to do that. I also run a report at the end of the month of all open anticipated payment accounts. The only down side is that occasionally we will have to re-do a patient's statement because maybe their insurance terminated or they changed plans, etc.
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We send those also. I had to remind them to not put "self pay" on the medicaid accounts because our system calculates the payments and drop bills to self pay. So statements will go out to them when they have no balance. Same would apply to Medicare & aarp etc. I just basically changed the % so that 0 goes to self pay and if needed I can move the balance.