Author Topic: Expenses incurred during lapse in coverage  (Read 110 times)

abhilashanilkumar

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Expenses incurred during lapse in coverage
« on: September 21, 2020, 10:55:03 AM »
Could you help some what does mean by "Expenses incurred during lapse in coverage" and how can i resolve this denial.

Thanks in Advance,

Michele

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Re: Expenses incurred during lapse in coverage
« Reply #1 on: September 21, 2020, 07:36:17 PM »
It means the patient did not have coverage at the time of service.  You must bill the patient.
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david

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Re: Expenses incurred during lapse in coverage
« Reply #2 on: October 15, 2020, 05:40:47 AM »
its means required insurance is expired. Patient is responsible for outstanding balance.

Nick D

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Re: Expenses incurred during lapse in coverage
« Reply #3 on: October 19, 2020, 10:38:04 AM »
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)
OON Facilities Billing Manager

Michele

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Re: Expenses incurred during lapse in coverage
« Reply #4 on: October 20, 2020, 09:15:57 AM »
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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