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General Category => General Questions => : abhilashanilkumar September 21, 2020, 01:55:03 PM

: Expenses incurred during lapse in coverage
: abhilashanilkumar September 21, 2020, 01:55:03 PM
Could you help some what does mean by "Expenses incurred during lapse in coverage" and how can i resolve this denial.

Thanks in Advance,
: Re: Expenses incurred during lapse in coverage
: Michele September 21, 2020, 10:36:17 PM
It means the patient did not have coverage at the time of service.  You must bill the patient.
: Re: Expenses incurred during lapse in coverage
: david October 15, 2020, 08:40:47 AM
its means required insurance is expired. Patient is responsible for outstanding balance.
: Re: Expenses incurred during lapse in coverage
: Nick D October 19, 2020, 01:38:04 PM
It means the patient did not have coverage at the time of service.  You must bill the patient.
Michelle,
If they try to recoup after a retro-termination. Do you refund the insurance the money or do you tell insurance company to contact patient? (ERISA question)
: Re: Expenses incurred during lapse in coverage
: Michele October 20, 2020, 12:15:57 PM
According the the ACA it is illegal for insurance companies to do recisions unless the patient committed fraud or deliberately lied.  https://www.verywellhealth.com/health-insurance-rescission-2615206

However the issue is that if the provider participates with the insurance carrier they will just deduct it from future payments.
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