Medical Billing Forum

Billing => Billing => : Sivakumar October 14, 2013, 03:10:59 AM

: Copay Adjustment
: Sivakumar October 14, 2013, 03:10:59 AM

Hi Guys,

Could you please clarify, whether shall we bill the initial visit copay to the patient if the claim has denied for untimely filing. Few of my staff suggest to bill the patient because it's the only prophet for our provider and others suggested to write-off since we crossed the limit to file the claim. Please advise.

Payer - United Healthcare

Thank You!!

: Re: Copay Adjustment
: rdmoore2003 October 14, 2013, 07:36:53 PM

look at your contract.....

: Re: Copay Adjustment
: PMRNC October 15, 2013, 10:19:47 AM

look at your contract.....

Ditto, but I can tell you most won't allow for it. The ones that do, be prepared for the patient to put up a fight if the claim was never submitted, that copay is a "cost sharing" provision of their policy. Your contract will tell you if you can or cannot bill the patient.

: Re: Copay Adjustment
: Sivakumar October 16, 2013, 06:50:47 AM

Thanks for your valuable response..  :)