Wiki Denials

[CindySREC]

What is the official ruling on charges that are denied from an insurance company saying that an authorization was not obtained? Is the patient still responsible for any part of the charge or does it need to be totally written off?

 

[mitchellde]

how can you justify billing a patient when the denial is the fault of the office not obtaining the authorization?

 

[CodingKing]

Total write off if you are contracted, patient liable if non-par.

 

[CindySREC]

how can you justify billing a patient when the denial is the fault of the office not obtaining the authorization?

Thanks for the advice. I was thinking the same. I was just wondering if the patient would still be responsible for what would be their part even if insurance had paid. I am new at all of this and was just asking.

 

[CindySREC]

Total write off if you are contracted, patient liable if non-par.

Thanks for the response.

 

[daedolos]

You could always apply for the retro-auth. I've had 30% success on that alone. Also, usually on the EOB, there is a section stating that patient does not bear responsibility.

Peace
@_*

 

[CindySREC]

You could always apply for the retro-auth. I've had 30% success on that alone. Also, usually on the EOB, there is a section stating that patient does not bear responsibility.

Peace
@_*

Thank you for your response. We have tried and failed. Do you have a secret to share on this? LOL

 

[KN]

What is the official ruling on charges that are denied from an insurance company saying that an authorization was not obtained? Is the patient still responsible for any part of the charge or does it need to be totally written off?

Were you advised an authorization was necessary? You may have appeal rights if they advised you incorrectly.